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Ipilimumab eller højdosis interferon Alfa-2b til behandling af patienter med højrisikostadie III-IV melanom, der er blevet fjernet ved kirurgi

14. februar 2024 opdateret af: National Cancer Institute (NCI)

Et fase III randomiseret studie af adjuverende ipilimumab anti-CTLA4-terapi versus højdosis interferon a-2b til resekeret højrisiko melanom

Dette randomiserede fase III-studie undersøger ipilimumab for at se, hvor godt det virker sammenlignet med højdosis interferon alfa-2b til behandling af patienter med højrisikostadie III-IV melanom, som er blevet fjernet ved kirurgi. Immunterapi med monoklonale antistoffer, såsom ipilimumab, kan hjælpe kroppens immunsystem til at angribe kræften og kan forstyrre tumorcellernes evne til at vokse og sprede sig. Interferon alfa-2b kan interferere med væksten af tumorceller og bremse væksten af melanom og andre kræftformer. Det vides endnu ikke, om ipilimumab er mere effektivt end interferon alfa-2b til behandling af patienter med melanom.

Studieoversigt

Status

Aktiv, ikke rekrutterende

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

PRIMÆRE MÅL:

I. At evaluere recidivfri overlevelse (RFS) mellem patienter randomiseret til at modtage postoperativt adjuverende ipilimumab givet ved enten 10 mg/kg (høj dosis ipilimumab; HIP) eller 3 mg/kg (lav dosis ipilimumab: LIP) versus de randomiserede at modtage højdosis interferon alfa-2b (HDI) ved at anvende et hierarkisk design, der vurderer HIP versus HDI først og LIP versus HDI andet (hvis den første sammenligning er signifikant).

II. At evaluere den samlede overlevelse (OS) mellem patienter, der er randomiseret til at modtage postoperativt adjuverende ipilimumab givet ved enten 10 mg/kg (HIP) eller 3 mg/kg (LIP) versus dem, der er randomiseret til at modtage HDI ved at anvende et hierarkisk design, der først vurderer HIP versus HDI og LIP versus HDI sekund (hvis den første sammenligning er signifikant).

SEKUNDÆRE MÅL:

I. At evaluere sikkerhed og tolerabilitet af postoperativ adjuverende ipilimumab-behandling givet ved enten 10 mg/kg (HIP) eller 3 mg/kg (LIP).

II. Blandt patienter, der er tilmeldt Clinical Community Oncology-programmer (CCOP'er), for at sammenligne den globale livskvalitet (QOL) mellem ipilimumab-armene versus HDI ved hjælp af Functional Assessment of Cancer Therapy (FACT)-General (G) form og for at evaluere effekten af behandlingen -relaterede bivirkninger, som kan have en indvirkning på de sundhedsrelaterede domæner af QOL ved hjælp af Functional Assessment of Chronic Illness Therapy (FACIT)-diarré (D) og FACT-biological response modifiers (BRM).

OVERSIGT: Patienter i alderen >= 18 år randomiseres til arme A, B eller C, og patienter i alderen 12-17 randomiseres til arme D, E eller F.

ARM A: Patienter får induktionshøjdosis ipilimumab intravenøst (IV) over 90 minutter på dag 1. Behandlingen gentages hver 21. dag i i alt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Fra og med uge 24 får patienterne vedligeholdelseshøjdosis ipilimumab IV over 90 minutter på dag 1. Behandlingen gentages hver 90. dag i maksimalt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. (lukket optjening pr. 4/4/14) (voksenoptjening er afsluttet til arme A, B og C pr. 15/8/2014)

ARM B: Patienter får induktionshøjdosis rekombinant interferon alfa-2b IV over 20 minutter på dag 1-5, 8-12, 15-19 og 22-26 i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienterne modtager derefter vedligeholdelseshøjdosis rekombinant interferon alfa-2b subkutant (SC) på dag 1, 3 og 5. Behandlingen gentages hver uge i 48 uger i fravær af sygdomsprogression eller uacceptabel toksicitet. (voksenopbygning er afsluttet til arme A, B og C pr. 15/8/2014)

ARM C: Patienter får induktion i lavdosis ipilimumab IV over 90 minutter på dag 1. Behandlingen gentages hver 21. dag i i alt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Fra uge 24 får patienterne vedligeholdelses lavdosis ipilimumab IV over 90 minutter på dag 1. Behandlingen gentages hver 90. dag i maksimalt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. (voksenopbygning er afsluttet til arme A, B og C pr. 15/8/2014)

ARM D: Patienter får induktionshøjdosis ipilimumab IV over 90 minutter på dag 1. Behandlingen gentages hver 21. dag i i alt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Fra og med uge 24 får patienterne vedligeholdelseshøjdosis ipilimumab IV over 90 minutter på dag 1. Behandlingen gentages hver 90. dag i maksimalt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet.

ARM E: Patienter får induktionshøjdosis rekombinant interferon alfa-2b IV over 20 minutter på dag 1-5, 8-12, 15-19 og 22-26 i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienterne modtager derefter vedligeholdelseshøjdosis rekombinant interferon alfa-2b SC på dag 1, 3 og 5. Behandlingen gentages hver uge i 48 uger i fravær af sygdomsprogression eller uacceptabel toksicitet

ARM F: Patienter får induktion i lavdosis ipilimumab IV over 90 minutter på dag 1. Behandlingen gentages hver 21. dag i i alt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Fra uge 24 får patienterne vedligeholdelses lavdosis ipilimumab IV over 90 minutter på dag 1. Behandlingen gentages hver 90. dag i maksimalt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet.

Efter afslutning af studieterapien følges patienterne op hver 3. måned i 2 år, hver 6. måned i 3 år og derefter årligt i op til 15 år.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

1673

Fase

Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

Canada
- Alberta
  - Edmonton, Alberta, Canada, T6G 1Z2
    - Cross Cancer Institute
- Manitoba
  - Winnipeg, Manitoba, Canada, R3E 0V9
    - CancerCare Manitoba
- Ontario
  - Kitchener, Ontario, Canada, N2G 1G3
    - Grand River Regional Cancer Centre at Grand River Hospital
  - Ottawa, Ontario, Canada, K1H 8L6
    - Ottawa Hospital and Cancer Center-General Campus
  - Sudbury, Ontario, Canada, P3E 5J1
    - Health Sciences North
  - Toronto, Ontario, Canada, M5G 2M9
    - University Health Network-Princess Margaret Hospital
  - Toronto, Ontario, Canada, M4N 3M5
    - Odette Cancer Centre- Sunnybrook Health Sciences Centre
- Quebec
  - Montreal, Quebec, Canada, H2L 4M1
    - CHUM - Hopital Notre-Dame
  - Montreal, Quebec, Canada, H2W 1S6
    - McGill University Department of Oncology
  - Montreal, Quebec, Canada, H2X 3E4
    - CHUM - Centre Hospitalier de l'Universite de Montreal
Forenede Stater
- Alabama
  - Birmingham, Alabama, Forenede Stater, 35233
    - University of Alabama at Birmingham Cancer Center
  - Mobile, Alabama, Forenede Stater, 36688
    - University of South Alabama Mitchell Cancer Institute
  - Mobile, Alabama, Forenede Stater, 36608
    - Providence Hospital
- Alaska
  - Anchorage, Alaska, Forenede Stater, 99508
    - Providence Alaska Medical Center
  - Anchorage, Alaska, Forenede Stater, 99508
    - Alaska Regional Hospital
  - Fairbanks, Alaska, Forenede Stater, 99701
    - Fairbanks Memorial Hospital
- Arizona
  - Gilbert, Arizona, Forenede Stater, 85234
    - Banner MD Anderson Cancer Center
  - Tucson, Arizona, Forenede Stater, 85704
    - University of Arizona Cancer Center-Orange Grove Campus
  - Tucson, Arizona, Forenede Stater, 85719
    - Banner University Medical Center - Tucson
  - Tucson, Arizona, Forenede Stater, 85719
    - University of Arizona Cancer Center-North Campus
- Arkansas
  - Fort Smith, Arkansas, Forenede Stater, 72903
    - Mercy Hospital Fort Smith
  - Jonesboro, Arkansas, Forenede Stater, 72401
    - NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
  - Little Rock, Arkansas, Forenede Stater, 72205
    - University of Arkansas for Medical Sciences
  - Little Rock, Arkansas, Forenede Stater, 72205
    - John L McClellan Memorial Veterans Hospital
  - Rogers, Arkansas, Forenede Stater, 72758
    - Highlands Oncology Group - Rogers
- California
  - Antioch, California, Forenede Stater, 94531
    - Kaiser Permanente-Deer Valley Medical Center
  - Arroyo Grande, California, Forenede Stater, 93420
    - PCR Oncology
  - Auburn, California, Forenede Stater, 95602
    - Sutter Auburn Faith Hospital
  - Auburn, California, Forenede Stater, 95603
    - Sutter Cancer Centers Radiation Oncology Services-Auburn
  - Cameron Park, California, Forenede Stater, 95682
    - Sutter Cancer Centers Radiation Oncology Services-Cameron Park
  - Davis, California, Forenede Stater, 95616
    - Sutter Davis Hospital
  - Fremont, California, Forenede Stater, 94538
    - Kaiser Permanente-Fremont
  - Fresno, California, Forenede Stater, 93720
    - Kaiser Permanente-Fresno
  - Fullerton, California, Forenede Stater, 92835
    - Saint Jude Medical Center
  - Greenbrae, California, Forenede Stater, 94904
    - Marin Cancer Care Inc
  - La Jolla, California, Forenede Stater, 92093
    - UC San Diego Moores Cancer Center
  - Los Angeles, California, Forenede Stater, 90095
    - UCLA / Jonsson Comprehensive Cancer Center
  - Los Angeles, California, Forenede Stater, 90095
    - Mattel Children's Hospital UCLA
  - Los Angeles, California, Forenede Stater, 90025
    - The Angeles Clinic and Research Institute - West Los Angeles Office
  - Modesto, California, Forenede Stater, 95355
    - Memorial Medical Center
  - Modesto, California, Forenede Stater, 95356
    - Kaiser Permanente-Modesto
  - Monterey, California, Forenede Stater, 93940
    - Community Hospital of Monterey Peninsula
  - Mountain View, California, Forenede Stater, 94040
    - Palo Alto Medical Foundation-Camino Division
  - Mountain View, California, Forenede Stater, 94040
    - Palo Alto Medical Foundation-Gynecologic Oncology
  - Novato, California, Forenede Stater, 94945
    - Sutter Cancer Research Consortium
  - Oakland, California, Forenede Stater, 94611
    - Kaiser Permanente-Oakland
  - Orange, California, Forenede Stater, 92868
    - UC Irvine Health/Chao Family Comprehensive Cancer Center
  - Orange, California, Forenede Stater, 92868
    - Saint Joseph Hospital - Orange
  - Palo Alto, California, Forenede Stater, 94304
    - VA Palo Alto Health Care System
  - Palo Alto, California, Forenede Stater, 94304
    - Stanford Cancer Institute Palo Alto
  - Palo Alto, California, Forenede Stater, 94301
    - Palo Alto Medical Foundation Health Care
  - Rancho Mirage, California, Forenede Stater, 92270
    - Eisenhower Medical Center
  - Redwood City, California, Forenede Stater, 94063
    - Kaiser Permanente-Redwood City
  - Richmond, California, Forenede Stater, 94801
    - Kaiser Permanente-Richmond
  - Roseville, California, Forenede Stater, 95661
    - Kaiser Permanente-Roseville
  - Roseville, California, Forenede Stater, 95661
    - Sutter Cancer Centers Radiation Oncology Services-Roseville
  - Roseville, California, Forenede Stater, 95661
    - Sutter Roseville Medical Center
  - Sacramento, California, Forenede Stater, 95816
    - Sutter Medical Center Sacramento
  - Sacramento, California, Forenede Stater, 95823
    - Kaiser Permanente-South Sacramento
  - Sacramento, California, Forenede Stater, 95825
    - Kaiser Permanente - Sacramento
  - San Diego, California, Forenede Stater, 92123
    - Sharp Memorial Hospital
  - San Francisco, California, Forenede Stater, 94115
    - Kaiser Permanente-San Francisco
  - San Francisco, California, Forenede Stater, 94115
    - California Pacific Medical Center-Pacific Campus
  - San Jose, California, Forenede Stater, 95119
    - Kaiser Permanente-Santa Teresa-San Jose
  - San Leandro, California, Forenede Stater, 94577
    - Kaiser Permanente San Leandro
  - San Luis Obispo, California, Forenede Stater, 93401
    - Pacific Central Coast Health Center-San Luis Obispo
  - San Rafael, California, Forenede Stater, 94903
    - Kaiser Permanente-San Rafael
  - Santa Clara, California, Forenede Stater, 95051
    - Kaiser Permanente Medical Center - Santa Clara
  - Santa Cruz, California, Forenede Stater, 95065
    - Palo Alto Medical Foundation-Santa Cruz
  - Santa Rosa, California, Forenede Stater, 95403
    - Kaiser Permanente-Santa Rosa
  - Santa Rosa, California, Forenede Stater, 95403
    - Sutter Pacific Medical Foundation
  - South San Francisco, California, Forenede Stater, 94080
    - Kaiser Permanente-South San Francisco
  - Stockton, California, Forenede Stater, 95210
    - Kaiser Permanente-Stockton
  - Sunnyvale, California, Forenede Stater, 94086
    - Palo Alto Medical Foundation-Sunnyvale
  - Vacaville, California, Forenede Stater, 95688
    - Kaiser Permanente Medical Center-Vacaville
  - Vacaville, California, Forenede Stater, 95687
    - Sutter Cancer Centers Radiation Oncology Services-Vacaville
  - Vallejo, California, Forenede Stater, 94589
    - Kaiser Permanente-Vallejo
  - Walnut Creek, California, Forenede Stater, 94596
    - Kaiser Permanente-Walnut Creek
  - Whittier, California, Forenede Stater, 90602
    - Presbyterian Intercommunity Hospital
- Colorado
  - Aurora, Colorado, Forenede Stater, 80012
    - Rocky Mountain Cancer Centers-Aurora
  - Aurora, Colorado, Forenede Stater, 80012
    - The Medical Center of Aurora
  - Aurora, Colorado, Forenede Stater, 80045
    - UCHealth University of Colorado Hospital
  - Boulder, Colorado, Forenede Stater, 80301
    - Boulder Community Hospital
  - Boulder, Colorado, Forenede Stater, 80304
    - Rocky Mountain Cancer Centers-Boulder
  - Colorado Springs, Colorado, Forenede Stater, 80907
    - Penrose-Saint Francis Healthcare
  - Colorado Springs, Colorado, Forenede Stater, 80909
    - UCHealth Memorial Hospital Central
  - Colorado Springs, Colorado, Forenede Stater, 80907
    - Rocky Mountain Cancer Centers-Penrose
  - Denver, Colorado, Forenede Stater, 80210
    - Porter Adventist Hospital
  - Denver, Colorado, Forenede Stater, 80205
    - Kaiser Permanente-Franklin
  - Denver, Colorado, Forenede Stater, 80218
    - Presbyterian - Saint Lukes Medical Center - Health One
  - Denver, Colorado, Forenede Stater, 80218
    - SCL Health Saint Joseph Hospital
  - Denver, Colorado, Forenede Stater, 80220
    - Rose Medical Center
  - Denver, Colorado, Forenede Stater, 80218
    - Rocky Mountain Cancer Centers-Midtown
  - Denver, Colorado, Forenede Stater, 80220
    - Rocky Mountain Cancer Centers-Rose
  - Denver, Colorado, Forenede Stater, 80218
    - Colorado Blood Cancer Institute
  - Denver, Colorado, Forenede Stater, 80222
    - Western States Cancer Research NCORP
  - Durango, Colorado, Forenede Stater, 81301
    - Mercy Medical Center
  - Edwards, Colorado, Forenede Stater, 81632
    - Shaw Cancer Center
  - Englewood, Colorado, Forenede Stater, 80113
    - Mountain Blue Cancer Care Center - Swedish
  - Englewood, Colorado, Forenede Stater, 80113
    - Swedish Medical Center
  - Fort Collins, Colorado, Forenede Stater, 80524
    - Poudre Valley Hospital
  - Golden, Colorado, Forenede Stater, 80401
    - Mountain Blue Cancer Care Center
  - Grand Junction, Colorado, Forenede Stater, 81501
    - Saint Mary's Hospital and Regional Medical Center
  - Greeley, Colorado, Forenede Stater, 80631
    - North Colorado Medical Center
  - Greenwood Village, Colorado, Forenede Stater, 80111
    - Rocky Mountain Cancer Centers-Greenwood Village
  - Lafayette, Colorado, Forenede Stater, 80026
    - Kaiser Permanente-Rock Creek
  - Lakewood, Colorado, Forenede Stater, 80228
    - Saint Anthony Hospital
  - Lakewood, Colorado, Forenede Stater, 80228
    - Rocky Mountain Cancer Centers-Lakewood
  - Littleton, Colorado, Forenede Stater, 80120
    - Rocky Mountain Cancer Centers-Littleton
  - Littleton, Colorado, Forenede Stater, 80122
    - Littleton Adventist Hospital
  - Lone Tree, Colorado, Forenede Stater, 80124
    - Kaiser Permanente-Lone Tree
  - Lone Tree, Colorado, Forenede Stater, 80124
    - Sky Ridge Medical Center
  - Lone Tree, Colorado, Forenede Stater, 80124
    - Rocky Mountain Cancer Centers-Sky Ridge
  - Longmont, Colorado, Forenede Stater, 80501
    - Longmont United Hospital
  - Longmont, Colorado, Forenede Stater, 80501
    - Rocky Mountain Cancer Centers-Longmont
  - Loveland, Colorado, Forenede Stater, 80539
    - McKee Medical Center
  - Parker, Colorado, Forenede Stater, 80138
    - Parker Adventist Hospital
  - Parker, Colorado, Forenede Stater, 80138
    - Rocky Mountain Cancer Centers-Parker
  - Pueblo, Colorado, Forenede Stater, 81004
    - Saint Mary Corwin Medical Center
  - Pueblo, Colorado, Forenede Stater, 81008
    - Rocky Mountain Cancer Centers - Pueblo
  - Thornton, Colorado, Forenede Stater, 80260
    - Rocky Mountain Cancer Centers-Thornton
  - Thornton, Colorado, Forenede Stater, 80229
    - North Suburban Medical Center
  - Wheat Ridge, Colorado, Forenede Stater, 80033
    - SCL Health Lutheran Medical Center
- Connecticut
  - Hartford, Connecticut, Forenede Stater, 06105
    - Smilow Cancer Hospital Care Center at Saint Francis
  - Hartford, Connecticut, Forenede Stater, 06102
    - Hartford Hospital
  - Manchester, Connecticut, Forenede Stater, 06040
    - Manchester Memorial Hospital
  - New Britain, Connecticut, Forenede Stater, 06050
    - The Hospital of Central Connecticut
  - New Haven, Connecticut, Forenede Stater, 06520
    - Yale University
  - Norwich, Connecticut, Forenede Stater, 06360
    - Eastern Connecticut Hematology and Oncology Associates
  - Stamford, Connecticut, Forenede Stater, 06904
    - Stamford Hospital/Bennett Cancer Center
- Delaware
  - Lewes, Delaware, Forenede Stater, 19958
    - Beebe Medical Center
  - Newark, Delaware, Forenede Stater, 19713
    - Helen F Graham Cancer Center
  - Newark, Delaware, Forenede Stater, 19713
    - Delaware Clinical and Laboratory Physicians PA
  - Newark, Delaware, Forenede Stater, 19713
    - Medical Oncology Hematology Consultants PA
  - Newark, Delaware, Forenede Stater, 19718
    - Christiana Care Health System-Christiana Hospital
  - Newark, Delaware, Forenede Stater, 19713
    - Christiana Gynecologic Oncology LLC
  - Rehoboth Beach, Delaware, Forenede Stater, 19971
    - Beebe Health Campus
  - Seaford, Delaware, Forenede Stater, 19973
    - TidalHealth Nanticoke / Allen Cancer Center
  - Wilmington, Delaware, Forenede Stater, 19801
    - Christiana Care Health System-Wilmington Hospital
- District of Columbia
  - Washington, District of Columbia, Forenede Stater, 20010
    - MedStar Washington Hospital Center
  - Washington, District of Columbia, Forenede Stater, 20007
    - MedStar Georgetown University Hospital
  - Washington, District of Columbia, Forenede Stater, 20016
    - Sibley Memorial Hospital
- Florida
  - Altamonte Springs, Florida, Forenede Stater, 32701
    - AdventHealth Altamonte
  - Boca Raton, Florida, Forenede Stater, 33486
    - Boca Raton Regional Hospital
  - Daytona Beach, Florida, Forenede Stater, 32117
    - Florida Hospital Memorial Medical Center
  - Fort Lauderdale, Florida, Forenede Stater, 33308
    - Holy Cross Hospital
  - Gainesville, Florida, Forenede Stater, 32610
    - University of Florida Health Science Center - Gainesville
  - Hollywood, Florida, Forenede Stater, 33021
    - Memorial Regional Hospital/Joe DiMaggio Children's Hospital
  - Jacksonville, Florida, Forenede Stater, 32207
    - Baptist MD Anderson Cancer Center
  - Jacksonville, Florida, Forenede Stater, 32224-9980
    - Mayo Clinic in Florida
  - Jupiter, Florida, Forenede Stater, 33458
    - Jupiter Medical Center
  - Kissimmee, Florida, Forenede Stater, 34744
    - AdventHealth Kissimmee
  - Lakeland, Florida, Forenede Stater, 33805
    - Lakeland Regional Health Hollis Cancer Center
  - Miami, Florida, Forenede Stater, 33136
    - University of Miami Miller School of Medicine-Sylvester Cancer Center
  - Miami Beach, Florida, Forenede Stater, 33140
    - Mount Sinai Medical Center
  - Orange Park, Florida, Forenede Stater, 32073
    - 21st Century Oncology-Orange Park
  - Orlando, Florida, Forenede Stater, 32806
    - Orlando Health Cancer Institute
  - Orlando, Florida, Forenede Stater, 32803
    - AdventHealth Orlando
  - Orlando, Florida, Forenede Stater, 32822
    - AdventHealth East Orlando
  - Palatka, Florida, Forenede Stater, 32177
    - Cancer Center of Putnam
  - Pembroke Pines, Florida, Forenede Stater, 33028
    - Memorial Hospital West
  - Pensacola, Florida, Forenede Stater, 32504
    - Sacred Heart Hospital
  - Stuart, Florida, Forenede Stater, 34994
    - Martin Medical Center
  - Stuart, Florida, Forenede Stater, 34994
    - Robert and Carol Weissman Cancer Center at Martin Health
  - Stuart, Florida, Forenede Stater, 34997
    - Martin Hospital South
  - Tampa, Florida, Forenede Stater, 33612
    - Moffitt Cancer Center
  - Winter Park, Florida, Forenede Stater, 32792
    - AdventHealth Winter Park
- Georgia
  - Athens, Georgia, Forenede Stater, 30607
    - University Cancer and Blood Center LLC
  - Atlanta, Georgia, Forenede Stater, 30322
    - Emory University Hospital/Winship Cancer Institute
  - Atlanta, Georgia, Forenede Stater, 30342
    - Northside Hospital
  - Atlanta, Georgia, Forenede Stater, 30342
    - Atlanta Regional CCOP
  - Augusta, Georgia, Forenede Stater, 30912
    - Augusta University Medical Center
  - Columbus, Georgia, Forenede Stater, 31904
    - John B Amos Cancer Center
  - Gainesville, Georgia, Forenede Stater, 30501
    - Northeast Georgia Medical Center-Gainesville
  - Macon, Georgia, Forenede Stater, 31201
    - Medical Center of Central Georgia
  - Savannah, Georgia, Forenede Stater, 31405
    - Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
  - Savannah, Georgia, Forenede Stater, 31404
    - Memorial Health University Medical Center
  - Valdosta, Georgia, Forenede Stater, 31602
    - South Georgia Medical Center/Pearlman Cancer Center
- Hawaii
  - 'Aiea, Hawaii, Forenede Stater, 96701
    - Pali Momi Medical Center
  - 'Aiea, Hawaii, Forenede Stater, 96701
    - Queen's Cancer Center - Pearlridge
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Queen's Medical Center
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Hawaii Cancer Care Inc - Waterfront Plaza
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Straub Clinic and Hospital
  - Honolulu, Hawaii, Forenede Stater, 96813
    - University of Hawaii Cancer Center
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Hawaii Cancer Care Inc-Liliha
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Kuakini Medical Center
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Queen's Cancer Center - Kuakini
  - Honolulu, Hawaii, Forenede Stater, 96826
    - Kapiolani Medical Center for Women and Children
  - Honolulu, Hawaii, Forenede Stater, 96819
    - Kaiser Permanente Moanalua Medical Center
  - Kailua, Hawaii, Forenede Stater, 96734
    - Castle Medical Center
  - Lihue, Hawaii, Forenede Stater, 96766
    - Wilcox Memorial Hospital and Kauai Medical Clinic
- Idaho
  - Boise, Idaho, Forenede Stater, 83706
    - Saint Alphonsus Cancer Care Center-Boise
  - Boise, Idaho, Forenede Stater, 83712
    - Saint Luke's Cancer Institute - Boise
  - Fruitland, Idaho, Forenede Stater, 83619
    - Saint Luke's Cancer Institute - Fruitland
  - Lewiston, Idaho, Forenede Stater, 83501
    - Saint Joseph Regional Medical Center
  - Meridian, Idaho, Forenede Stater, 83642
    - Saint Luke's Cancer Institute - Meridian
  - Nampa, Idaho, Forenede Stater, 83686
    - Saint Luke's Cancer Institute - Nampa
  - Post Falls, Idaho, Forenede Stater, 83854
    - Kootenai Clinic Cancer Services - Post Falls
  - Twin Falls, Idaho, Forenede Stater, 83301
    - Saint Luke's Cancer Institute - Twin Falls
- Illinois
  - Alton, Illinois, Forenede Stater, 62002
    - Saint Anthony's Health
  - Aurora, Illinois, Forenede Stater, 60504
    - Rush - Copley Medical Center
  - Berwyn, Illinois, Forenede Stater, 60402
    - Mac Neal Hospital
  - Bloomington, Illinois, Forenede Stater, 61704
    - Illinois CancerCare-Bloomington
  - Bloomington, Illinois, Forenede Stater, 61701
    - Saint Joseph Medical Center
  - Canton, Illinois, Forenede Stater, 61520
    - Illinois CancerCare-Canton
  - Canton, Illinois, Forenede Stater, 61520
    - Graham Hospital Association
  - Carbondale, Illinois, Forenede Stater, 62902
    - Memorial Hospital of Carbondale
  - Carthage, Illinois, Forenede Stater, 62321
    - Illinois CancerCare-Carthage
  - Carthage, Illinois, Forenede Stater, 62321
    - Memorial Hospital
  - Centralia, Illinois, Forenede Stater, 62801
    - Centralia Oncology Clinic
  - Chicago, Illinois, Forenede Stater, 60611
    - Northwestern University
  - Chicago, Illinois, Forenede Stater, 60612
    - Rush University Medical Center
  - Chicago, Illinois, Forenede Stater, 60637
    - University of Chicago Comprehensive Cancer Center
  - Chicago, Illinois, Forenede Stater, 60612
    - University of Illinois
  - Chicago, Illinois, Forenede Stater, 60657
    - UChicago Medicine Comprehensive Cancer Center - Saint Joseph Hospital
  - Chicago, Illinois, Forenede Stater, 60611
    - Hematology and Oncology Associates
  - Chicago, Illinois, Forenede Stater, 60631
    - Presence Resurrection Medical Center
  - Chicago, Illinois, Forenede Stater, 60640
    - Weiss Memorial Hospital
  - Chicago, Illinois, Forenede Stater, 60657
    - Advocate Illinois Masonic Medical Center
  - Danville, Illinois, Forenede Stater, 61832
    - Carle at The Riverfront
  - Decatur, Illinois, Forenede Stater, 62526
    - Decatur Memorial Hospital
  - Decatur, Illinois, Forenede Stater, 62526
    - Cancer Care Specialists of Illinois - Decatur
  - Decatur, Illinois, Forenede Stater, 62526
    - Heartland Cancer Research NCORP
  - Downers Grove, Illinois, Forenede Stater, 60515
    - Advocate Good Samaritan Hospital
  - Effingham, Illinois, Forenede Stater, 62401
    - Crossroads Cancer Center
  - Effingham, Illinois, Forenede Stater, 62401
    - Carle Physician Group-Effingham
  - Elgin, Illinois, Forenede Stater, 60123
    - Advocate Sherman Hospital
  - Elk Grove Village, Illinois, Forenede Stater, 60007
    - Ascension Alexian Brothers - Elk Grove Village
  - Eureka, Illinois, Forenede Stater, 61530
    - Illinois CancerCare-Eureka
  - Eureka, Illinois, Forenede Stater, 61530
    - Eureka Hospital
  - Evanston, Illinois, Forenede Stater, 60201
    - NorthShore University HealthSystem-Evanston Hospital
  - Galesburg, Illinois, Forenede Stater, 61401
    - Western Illinois Cancer Treatment Center
  - Galesburg, Illinois, Forenede Stater, 61401
    - Illinois CancerCare-Galesburg
  - Geneva, Illinois, Forenede Stater, 60134
    - Northwestern Medicine Cancer Center Delnor
  - Harvey, Illinois, Forenede Stater, 60426
    - Ingalls Memorial Hospital
  - Havana, Illinois, Forenede Stater, 62644
    - Mason District Hospital
  - Havana, Illinois, Forenede Stater, 62644
    - Illinois CancerCare-Havana
  - Highland Park, Illinois, Forenede Stater, 60035
    - Hematology Oncology Associates of Illinois-Highland Park
  - Hines, Illinois, Forenede Stater, 60141
    - Edward Hines Jr VA Hospital
  - Hinsdale, Illinois, Forenede Stater, 60521
    - Hinsdale Hematology Oncology Associates Incorporated
  - Kankakee, Illinois, Forenede Stater, 60901
    - Presence Saint Mary's Hospital
  - Kewanee, Illinois, Forenede Stater, 61443
    - Illinois CancerCare-Kewanee Clinic
  - Libertyville, Illinois, Forenede Stater, 60048
    - AMG Libertyville - Oncology
  - Macomb, Illinois, Forenede Stater, 61455
    - Illinois CancerCare-Macomb
  - Macomb, Illinois, Forenede Stater, 61455
    - Mcdonough District Hospital
  - Mattoon, Illinois, Forenede Stater, 61938
    - Carle Physician Group-Mattoon/Charleston
  - Maywood, Illinois, Forenede Stater, 60153
    - Loyola University Medical Center
  - Moline, Illinois, Forenede Stater, 61265
    - Garneau, Stewart C MD (UIA Investigator)
  - Moline, Illinois, Forenede Stater, 61265
    - Porubcin, Michael MD (UIA Investigator)
  - Moline, Illinois, Forenede Stater, 61265
    - Spector, David MD (UIA Investigator)
  - Moline, Illinois, Forenede Stater, 61265
    - Trinity Medical Center
  - Monmouth, Illinois, Forenede Stater, 61462
    - Illinois CancerCare-Monmouth
  - Monmouth, Illinois, Forenede Stater, 61462
    - Holy Family Medical Center
  - Mount Vernon, Illinois, Forenede Stater, 62864
    - Good Samaritan Regional Health Center
  - New Lenox, Illinois, Forenede Stater, 60451
    - UC Comprehensive Cancer Center at Silver Cross
  - Niles, Illinois, Forenede Stater, 60714
    - Illinois Cancer Specialists-Niles
  - Normal, Illinois, Forenede Stater, 61761
    - Carle Cancer Institute Normal
  - Normal, Illinois, Forenede Stater, 61761
    - Bromenn Regional Medical Center
  - Normal, Illinois, Forenede Stater, 61761
    - Illinois CancerCare-Community Cancer Center
  - Normal, Illinois, Forenede Stater, 61761
    - Mid-Illinois Hematology Oncology Associates Limited
  - Oak Lawn, Illinois, Forenede Stater, 60453-2699
    - Advocate Christ Medical Center
  - Ottawa, Illinois, Forenede Stater, 61350
    - Illinois CancerCare-Ottawa Clinic
  - Ottawa, Illinois, Forenede Stater, 61350
    - Radiation Oncology of Northern Illinois
  - Ottawa, Illinois, Forenede Stater, 61350
    - Ottawa Regional Hospital and Healthcare Center
  - Pekin, Illinois, Forenede Stater, 61554
    - Illinois CancerCare-Pekin
  - Pekin, Illinois, Forenede Stater, 61554
    - OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
  - Peoria, Illinois, Forenede Stater, 61636
    - Methodist Medical Center of Illinois
  - Peoria, Illinois, Forenede Stater, 61637
    - OSF Saint Francis Medical Center
  - Peoria, Illinois, Forenede Stater, 61615
    - Illinois CancerCare-Peoria
  - Peoria, Illinois, Forenede Stater, 61615
    - OSF Saint Francis Radiation Oncology at Peoria Cancer Center
  - Peoria, Illinois, Forenede Stater, 61614
    - Proctor Hospital
  - Peru, Illinois, Forenede Stater, 61354
    - Illinois CancerCare-Peru
  - Peru, Illinois, Forenede Stater, 61354
    - Valley Radiation Oncology
  - Peru, Illinois, Forenede Stater, 61354
    - Illinois Valley Hospital
  - Princeton, Illinois, Forenede Stater, 61356
    - Illinois CancerCare-Princeton
  - Princeton, Illinois, Forenede Stater, 61356
    - Perry Memorial Hospital
  - River Forest, Illinois, Forenede Stater, 60305
    - West Suburban Medical Center
  - Rockford, Illinois, Forenede Stater, 61114
    - SwedishAmerican Regional Cancer Center/ACT
  - Rockford, Illinois, Forenede Stater, 61108
    - OSF Saint Anthony Medical Center
  - Rockford, Illinois, Forenede Stater, 61104
    - Swedish American Hospital
  - Skokie, Illinois, Forenede Stater, 60076
    - Hematology Oncology Associates of Illinois - Skokie
  - Spring Valley, Illinois, Forenede Stater, 61362
    - Illinois CancerCare-Spring Valley
  - Springfield, Illinois, Forenede Stater, 62781
    - Memorial Medical Center
  - Springfield, Illinois, Forenede Stater, 62702
    - Southern Illinois University School of Medicine
  - Springfield, Illinois, Forenede Stater, 62702
    - Springfield Clinic
  - Springfield, Illinois, Forenede Stater, 62702
    - Central Illinois Hematology Oncology Center
  - Urbana, Illinois, Forenede Stater, 61801
    - Carle Cancer Center
  - Urbana, Illinois, Forenede Stater, 61801
    - The Carle Foundation Hospital
  - Warrenville, Illinois, Forenede Stater, 60555
    - Northwestern Medicine Cancer Center Warrenville
  - Yorkville, Illinois, Forenede Stater, 60560
    - Rush-Copley Healthcare Center
- Indiana
  - Beech Grove, Indiana, Forenede Stater, 46107
    - Franciscan Saint Francis Health-Beech Grove
  - Elkhart, Indiana, Forenede Stater, 46515
    - Elkhart General Hospital
  - Elkhart, Indiana, Forenede Stater, 46514
    - Michiana Hematology Oncology PC-Elkhart
  - Elkhart, Indiana, Forenede Stater, 46514-2098
    - Elkhart Clinic
  - Fort Wayne, Indiana, Forenede Stater, 46845
    - Fort Wayne Medical Oncology and Hematology Inc-Parkview
  - Indianapolis, Indiana, Forenede Stater, 46237
    - Franciscan Health Indianapolis
  - Indianapolis, Indiana, Forenede Stater, 46202
    - Indiana University/Melvin and Bren Simon Cancer Center
  - Indianapolis, Indiana, Forenede Stater, 46219
    - Community Cancer Center East
  - Indianapolis, Indiana, Forenede Stater, 46256
    - Community Cancer Center North
  - Kokomo, Indiana, Forenede Stater, 46904
    - Community Howard Regional Health
  - La Porte, Indiana, Forenede Stater, 46350
    - IU Health La Porte Hospital
  - Michigan City, Indiana, Forenede Stater, 46360
    - Franciscan Saint Anthony Health-Michigan City
  - Michigan City, Indiana, Forenede Stater, 46360
    - Woodland Cancer Care Center
  - Mishawaka, Indiana, Forenede Stater, 46545
    - Michiana Hematology Oncology PC-Mishawaka
  - Mishawaka, Indiana, Forenede Stater, 46545
    - Saint Joseph Regional Medical Center-Mishawaka
  - Muncie, Indiana, Forenede Stater, 47303
    - IU Health Ball Memorial Hospital
  - Munster, Indiana, Forenede Stater, 46321
    - The Community Hospital
  - Plymouth, Indiana, Forenede Stater, 46563
    - Michiana Hematology Oncology PC-Plymouth
  - Richmond, Indiana, Forenede Stater, 47374
    - Reid Health
  - South Bend, Indiana, Forenede Stater, 46601
    - Memorial Hospital of South Bend
  - South Bend, Indiana, Forenede Stater, 46628
    - Northern Indiana Cancer Research Consortium
  - Westville, Indiana, Forenede Stater, 46391
    - Michiana Hematology Oncology PC-Westville
- Iowa
  - Ames, Iowa, Forenede Stater, 50010
    - Mary Greeley Medical Center
  - Ames, Iowa, Forenede Stater, 50010
    - McFarland Clinic - Ames
  - Bettendorf, Iowa, Forenede Stater, 52722
    - Constantinou, Costas L MD (UIA Investigator)
  - Boone, Iowa, Forenede Stater, 50036
    - McFarland Clinic - Boone
  - Cedar Rapids, Iowa, Forenede Stater, 52403
    - Mercy Hospital
  - Cedar Rapids, Iowa, Forenede Stater, 52403
    - Oncology Associates at Mercy Medical Center
  - Cedar Rapids, Iowa, Forenede Stater, 52402
    - Saint Luke's Hospital
  - Cedar Rapids, Iowa, Forenede Stater, 52402
    - Physicians' Clinic of Iowa PC
  - Clive, Iowa, Forenede Stater, 50325
    - Mercy Cancer Center-West Lakes
  - Clive, Iowa, Forenede Stater, 50325
    - Medical Oncology and Hematology Associates-West Des Moines
  - Council Bluffs, Iowa, Forenede Stater, 51503
    - Alegent Health Mercy Hospital
  - Des Moines, Iowa, Forenede Stater, 50309
    - Iowa Methodist Medical Center
  - Des Moines, Iowa, Forenede Stater, 50314
    - Mercy Medical Center - Des Moines
  - Des Moines, Iowa, Forenede Stater, 50309
    - Medical Oncology and Hematology Associates-Des Moines
  - Des Moines, Iowa, Forenede Stater, 50314
    - Mission Cancer and Blood - Laurel
  - Des Moines, Iowa, Forenede Stater, 50316
    - Iowa Lutheran Hospital
  - Des Moines, Iowa, Forenede Stater, 50309
    - Iowa-Wide Oncology Research Coalition NCORP
  - Fort Dodge, Iowa, Forenede Stater, 50501
    - McFarland Clinic - Trinity Cancer Center
  - Iowa City, Iowa, Forenede Stater, 52242
    - University of Iowa/Holden Comprehensive Cancer Center
  - Jefferson, Iowa, Forenede Stater, 50129
    - McFarland Clinic - Jefferson
  - Marshalltown, Iowa, Forenede Stater, 50158
    - McFarland Clinic - Marshalltown
  - Sioux City, Iowa, Forenede Stater, 51101
    - Siouxland Regional Cancer Center
  - Sioux City, Iowa, Forenede Stater, 51102
    - Mercy Medical Center-Sioux City
  - Sioux City, Iowa, Forenede Stater, 51104
    - Saint Luke's Regional Medical Center
  - Waterloo, Iowa, Forenede Stater, 50702
    - MercyOne Waterloo Cancer Center
  - West Des Moines, Iowa, Forenede Stater, 50266-7700
    - Methodist West Hospital
  - West Des Moines, Iowa, Forenede Stater, 50266
    - Mercy Medical Center-West Lakes
- Kansas
  - Chanute, Kansas, Forenede Stater, 66720
    - Cancer Center of Kansas - Chanute
  - Dodge City, Kansas, Forenede Stater, 67801
    - Cancer Center of Kansas - Dodge City
  - El Dorado, Kansas, Forenede Stater, 67042
    - Cancer Center of Kansas - El Dorado
  - Emporia, Kansas, Forenede Stater, 66801
    - Newman Regional Health
  - Fort Scott, Kansas, Forenede Stater, 66701
    - Cancer Center of Kansas - Fort Scott
  - Garden City, Kansas, Forenede Stater, 67846
    - Saint Catherine Hospital
  - Great Bend, Kansas, Forenede Stater, 67530
    - Saint Rose Ambulatory and Surgery Center
  - Hays, Kansas, Forenede Stater, 67601
    - HaysMed University of Kansas Health System
  - Hutchinson, Kansas, Forenede Stater, 67502
    - Hutchinson Regional Medical Center
  - Independence, Kansas, Forenede Stater, 67301
    - Cancer Center of Kansas-Independence
  - Kansas City, Kansas, Forenede Stater, 66160
    - University of Kansas Cancer Center
  - Kansas City, Kansas, Forenede Stater, 66112
    - University of Kansas Cancer Center-West
  - Kingman, Kansas, Forenede Stater, 67068
    - Cancer Center of Kansas-Kingman
  - Lawrence, Kansas, Forenede Stater, 66044
    - Lawrence Memorial Hospital
  - Liberal, Kansas, Forenede Stater, 67905
    - Cancer Center of Kansas-Liberal
  - Manhattan, Kansas, Forenede Stater, 66502
    - Cancer Center of Kansas-Manhattan
  - McPherson, Kansas, Forenede Stater, 67460
    - Cancer Center of Kansas - McPherson
  - Newton, Kansas, Forenede Stater, 67114
    - Cancer Center of Kansas - Newton
  - Overland Park, Kansas, Forenede Stater, 66210
    - University of Kansas Cancer Center-Overland Park
  - Overland Park, Kansas, Forenede Stater, 66209
    - Menorah Medical Center
  - Overland Park, Kansas, Forenede Stater, 66213
    - Saint Luke's South Hospital
  - Parsons, Kansas, Forenede Stater, 67357
    - Cancer Center of Kansas - Parsons
  - Pittsburg, Kansas, Forenede Stater, 66762
    - Ascension Via Christi - Pittsburg
  - Prairie Village, Kansas, Forenede Stater, 66208
    - Kansas City NCI Community Oncology Research Program
  - Pratt, Kansas, Forenede Stater, 67124
    - Cancer Center of Kansas - Pratt
  - Salina, Kansas, Forenede Stater, 67401
    - Salina Regional Health Center
  - Salina, Kansas, Forenede Stater, 67401
    - Cancer Center of Kansas - Salina
  - Topeka, Kansas, Forenede Stater, 66606
    - University of Kansas Health System Saint Francis Campus
  - Topeka, Kansas, Forenede Stater, 66606
    - Cotton O'Neil Cancer Center / Stormont Vail Health
  - Wellington, Kansas, Forenede Stater, 67152
    - Cancer Center of Kansas - Wellington
  - Wichita, Kansas, Forenede Stater, 67214
    - Ascension Via Christi Hospitals Wichita
  - Wichita, Kansas, Forenede Stater, 67208
    - Cancer Center of Kansas-Wichita Medical Arts Tower
  - Wichita, Kansas, Forenede Stater, 67214
    - Cancer Center of Kansas - Wichita
  - Wichita, Kansas, Forenede Stater, 67208
    - Associates In Womens Health
  - Wichita, Kansas, Forenede Stater, 67214
    - Wichita NCI Community Oncology Research Program
  - Wichita, Kansas, Forenede Stater, 67214
    - Wesley Medical Center
  - Winfield, Kansas, Forenede Stater, 67156
    - Cancer Center of Kansas - Winfield
- Kentucky
  - Crestview Hills, Kentucky, Forenede Stater, 41017
    - Oncology Hematology Care Inc-Crestview
  - Lexington, Kentucky, Forenede Stater, 40536
    - University of Kentucky/Markey Cancer Center
  - Lexington, Kentucky, Forenede Stater, 40504
    - Saint Joseph Radiation Oncology Resource Center
  - Louisville, Kentucky, Forenede Stater, 40202
    - Jewish Hospital
  - Owensboro, Kentucky, Forenede Stater, 42303
    - Owensboro Health Mitchell Memorial Cancer Center
- Louisiana
  - Baton Rouge, Louisiana, Forenede Stater, 70809
    - Mary Bird Perkins Cancer Center
  - Baton Rouge, Louisiana, Forenede Stater, 70809
    - Ochsner Health Center-Summa
  - Covington, Louisiana, Forenede Stater, 70433
    - Ochsner Health Center-Covington
  - Monroe, Louisiana, Forenede Stater, 71202
    - Ochsner LSU Health Monroe Medical Center
  - New Orleans, Louisiana, Forenede Stater, 70121
    - Ochsner Medical Center Jefferson
  - New Orleans, Louisiana, Forenede Stater, 70112
    - University Medical Center New Orleans
  - New Orleans, Louisiana, Forenede Stater, 70112
    - Louisiana State University Health Science Center
  - New Orleans, Louisiana, Forenede Stater, 70115
    - Ochsner Baptist Medical Center
  - Shreveport, Louisiana, Forenede Stater, 71103
    - LSU Health Sciences Center at Shreveport
- Maine
  - Augusta, Maine, Forenede Stater, 04330
    - Harold Alfond Center for Cancer Care
  - Bangor, Maine, Forenede Stater, 04401
    - Eastern Maine Medical Center
  - Brewer, Maine, Forenede Stater, 04412
    - Lafayette Family Cancer Center-EMMC
  - Rockport, Maine, Forenede Stater, 04856
    - Penobscot Bay Medical Center
  - Scarborough, Maine, Forenede Stater, 04074
    - Maine Center for Cancer Medicine-Scarborough
  - York, Maine, Forenede Stater, 03909
    - York Hospital
- Maryland
  - Baltimore, Maryland, Forenede Stater, 21237
    - MedStar Franklin Square Medical Center/Weinberg Cancer Institute
  - Baltimore, Maryland, Forenede Stater, 21215
    - Sinai Hospital of Baltimore
  - Baltimore, Maryland, Forenede Stater, 21204
    - Greater Baltimore Medical Center
  - Baltimore, Maryland, Forenede Stater, 21229
    - Saint Agnes Hospital
  - Elkton, Maryland, Forenede Stater, 21921
    - Christiana Care - Union Hospital
  - Frederick, Maryland, Forenede Stater, 21701
    - Frederick Memorial Hospital
  - Randallstown, Maryland, Forenede Stater, 21133
    - Northwest Hospital Center
  - Rockville, Maryland, Forenede Stater, 20850
    - Maryland Oncology Hematology PA-Aquilino Cancer Center
  - Salisbury, Maryland, Forenede Stater, 21801
    - TidalHealth Peninsula Regional
- Massachusetts
  - Boston, Massachusetts, Forenede Stater, 02215
    - Beth Israel Deaconess Medical Center
  - Boston, Massachusetts, Forenede Stater, 02215
    - Dana-Farber Cancer Institute
  - Boston, Massachusetts, Forenede Stater, 02115
    - Brigham and Women's Hospital
  - Boston, Massachusetts, Forenede Stater, 02111
    - Tufts Medical Center
  - Boston, Massachusetts, Forenede Stater, 02118
    - Boston Medical Center
  - Boston, Massachusetts, Forenede Stater, 02114
    - Massachusetts General Hospital Cancer Center
  - Burlington, Massachusetts, Forenede Stater, 01805
    - Lahey Hospital and Medical Center
  - Danvers, Massachusetts, Forenede Stater, 01923
    - Mass General/North Shore Cancer Center
  - Pittsfield, Massachusetts, Forenede Stater, 01201
    - Berkshire Medical Center - Cancer Center
  - Springfield, Massachusetts, Forenede Stater, 01199
    - Baystate Medical Center
  - Worcester, Massachusetts, Forenede Stater, 01655
    - UMass Memorial Medical Center - University Campus
- Michigan
  - Adrian, Michigan, Forenede Stater, 49221
    - Bixby Medical Center
  - Adrian, Michigan, Forenede Stater, 49221
    - Hickman Cancer Center
  - Ann Arbor, Michigan, Forenede Stater, 48109
    - University of Michigan Comprehensive Cancer Center
  - Ann Arbor, Michigan, Forenede Stater, 48106
    - Saint Joseph Mercy Hospital
  - Ann Arbor, Michigan, Forenede Stater, 48106
    - Michigan Cancer Research Consortium NCORP
  - Battle Creek, Michigan, Forenede Stater, 49017
    - Bronson Battle Creek
  - Big Rapids, Michigan, Forenede Stater, 49307
    - Spectrum Health Big Rapids Hospital
  - Clarkston, Michigan, Forenede Stater, 48346
    - McLaren Cancer Institute-Clarkston
  - Dearborn, Michigan, Forenede Stater, 48124
    - Beaumont Hospital - Dearborn
  - Detroit, Michigan, Forenede Stater, 48202
    - Henry Ford Hospital
  - Detroit, Michigan, Forenede Stater, 48201
    - Wayne State University/Karmanos Cancer Institute
  - Detroit, Michigan, Forenede Stater, 48236
    - Ascension Saint John Hospital
  - Escanaba, Michigan, Forenede Stater, 49829
    - Green Bay Oncology - Escanaba
  - Farmington Hills, Michigan, Forenede Stater, 48336
    - Beaumont Hospital - Farmington Hills
  - Flint, Michigan, Forenede Stater, 48532
    - Genesys Regional Medical Center-West Flint Campus
  - Flint, Michigan, Forenede Stater, 48532
    - McLaren Cancer Institute-Flint
  - Flint, Michigan, Forenede Stater, 48532
    - Singh and Arora Hematology Oncology PC
  - Flint, Michigan, Forenede Stater, 48503
    - Hurley Medical Center
  - Flint, Michigan, Forenede Stater, 48503
    - Genesys Hurley Cancer Institute
  - Grand Blanc, Michigan, Forenede Stater, 48439
    - Genesys Regional Medical Center
  - Grand Rapids, Michigan, Forenede Stater, 49503
    - Spectrum Health at Butterworth Campus
  - Grand Rapids, Michigan, Forenede Stater, 49503
    - Cancer Research Consortium of West Michigan NCORP
  - Grand Rapids, Michigan, Forenede Stater, 49503
    - Trinity Health Grand Rapids Hospital
  - Iron Mountain, Michigan, Forenede Stater, 49801
    - Green Bay Oncology - Iron Mountain
  - Jackson, Michigan, Forenede Stater, 49201
    - Allegiance Health
  - Kalamazoo, Michigan, Forenede Stater, 49007
    - West Michigan Cancer Center
  - Lansing, Michigan, Forenede Stater, 48912
    - Sparrow Hospital
  - Lapeer, Michigan, Forenede Stater, 48446
    - McLaren Cancer Institute-Lapeer Region
  - Livonia, Michigan, Forenede Stater, 48154
    - Trinity Health Saint Mary Mercy Livonia Hospital
  - Marquette, Michigan, Forenede Stater, 49855
    - UP Health System Marquette
  - Monroe, Michigan, Forenede Stater, 48162
    - Mercy Memorial Hospital
  - Monroe, Michigan, Forenede Stater, 48162
    - Toledo Clinic Cancer Centers-Monroe
  - Mount Clemens, Michigan, Forenede Stater, 48043
    - McLaren Cancer Institute-Macomb
  - Muskegon, Michigan, Forenede Stater, 49444
    - Trinity Health Muskegon Hospital
  - Niles, Michigan, Forenede Stater, 49120
    - Corewell Health Lakeland Hospitals - Niles Hospital
  - Petoskey, Michigan, Forenede Stater, 49770
    - McLaren Cancer Institute-Northern Michigan
  - Pontiac, Michigan, Forenede Stater, 48341
    - Saint Joseph Mercy Oakland
  - Port Huron, Michigan, Forenede Stater, 48060
    - Lake Huron Medical Center
  - Reed City, Michigan, Forenede Stater, 49677
    - Corewell Health Reed City Hospital
  - Royal Oak, Michigan, Forenede Stater, 48073
    - William Beaumont Hospital-Royal Oak
  - Saginaw, Michigan, Forenede Stater, 48601
    - Ascension Saint Mary's Hospital
  - Saint Joseph, Michigan, Forenede Stater, 49085
    - Lakeland Medical Center Saint Joseph
  - Saint Joseph, Michigan, Forenede Stater, 49085
    - Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
  - Traverse City, Michigan, Forenede Stater, 49684
    - Munson Medical Center
  - Troy, Michigan, Forenede Stater, 48085
    - William Beaumont Hospital - Troy
  - Warren, Michigan, Forenede Stater, 48093
    - Saint John Macomb-Oakland Hospital
- Minnesota
  - Bemidji, Minnesota, Forenede Stater, 56601
    - Sanford Joe Lueken Cancer Center
  - Brainerd, Minnesota, Forenede Stater, 56401
    - Essentia Health Saint Joseph's Medical Center
  - Burnsville, Minnesota, Forenede Stater, 55337
    - Fairview Ridges Hospital
  - Coon Rapids, Minnesota, Forenede Stater, 55433
    - Mercy Hospital
  - Duluth, Minnesota, Forenede Stater, 55805
    - Essentia Health Cancer Center
  - Duluth, Minnesota, Forenede Stater, 55805
    - Essentia Health Saint Mary's Medical Center
  - Duluth, Minnesota, Forenede Stater, 55805
    - Miller-Dwan Hospital
  - Edina, Minnesota, Forenede Stater, 55435
    - Fairview Southdale Hospital
  - Fridley, Minnesota, Forenede Stater, 55432
    - Unity Hospital
  - Hutchinson, Minnesota, Forenede Stater, 55350
    - Hutchinson Area Health Care
  - Maplewood, Minnesota, Forenede Stater, 55109
    - Saint John's Hospital - Healtheast
  - Maplewood, Minnesota, Forenede Stater, 55109
    - Minnesota Oncology Hematology PA-Maplewood
  - Minneapolis, Minnesota, Forenede Stater, 55415
    - Hennepin County Medical Center
  - Minneapolis, Minnesota, Forenede Stater, 55407
    - Abbott-Northwestern Hospital
  - Minneapolis, Minnesota, Forenede Stater, 55454
    - Health Partners Inc
  - New Ulm, Minnesota, Forenede Stater, 56073
    - New Ulm Medical Center
  - Robbinsdale, Minnesota, Forenede Stater, 55422
    - North Memorial Medical Health Center
  - Saint Cloud, Minnesota, Forenede Stater, 56303
    - Coborn Cancer Center at Saint Cloud Hospital
  - Saint Cloud, Minnesota, Forenede Stater, 56303
    - Saint Cloud Hospital
  - Saint Louis Park, Minnesota, Forenede Stater, 55416
    - Park Nicollet Clinic - Saint Louis Park
  - Saint Louis Park, Minnesota, Forenede Stater, 55416
    - Metro Minnesota Community Oncology Research Consortium
  - Saint Paul, Minnesota, Forenede Stater, 55101
    - Regions Hospital
  - Saint Paul, Minnesota, Forenede Stater, 55102
    - United Hospital
  - Shakopee, Minnesota, Forenede Stater, 55379
    - Saint Francis Regional Medical Center
  - Stillwater, Minnesota, Forenede Stater, 55082
    - Lakeview Hospital
  - Waconia, Minnesota, Forenede Stater, 55387
    - Ridgeview Medical Center
  - Willmar, Minnesota, Forenede Stater, 56201
    - Rice Memorial Hospital
  - Woodbury, Minnesota, Forenede Stater, 55125
    - Minnesota Oncology Hematology PA-Woodbury
- Mississippi
  - Jackson, Mississippi, Forenede Stater, 39216
    - University of Mississippi Medical Center
- Missouri
  - Bolivar, Missouri, Forenede Stater, 65613
    - Central Care Cancer Center - Bolivar
  - Bonne Terre, Missouri, Forenede Stater, 63628
    - Parkland Health Center-Bonne Terre
  - Branson, Missouri, Forenede Stater, 65616
    - Cox Cancer Center Branson
  - Cape Girardeau, Missouri, Forenede Stater, 63703
    - Saint Francis Medical Center
  - Cape Girardeau, Missouri, Forenede Stater, 63703
    - Southeast Cancer Center
  - Columbia, Missouri, Forenede Stater, 65201
    - Veterans Administration
  - Columbia, Missouri, Forenede Stater, 65212
    - MU Health - University Hospital/Ellis Fischel Cancer Center
  - Independence, Missouri, Forenede Stater, 64057
    - Centerpoint Medical Center LLC
  - Jefferson City, Missouri, Forenede Stater, 65109
    - Capital Region Southwest Campus
  - Joplin, Missouri, Forenede Stater, 64804
    - Freeman Health System
  - Kansas City, Missouri, Forenede Stater, 64154
    - University of Kansas Cancer Center - North
  - Kansas City, Missouri, Forenede Stater, 64131
    - The University of Kansas Cancer Center-South
  - Kansas City, Missouri, Forenede Stater, 64111
    - Saint Luke's Hospital of Kansas City
  - Kansas City, Missouri, Forenede Stater, 64132
    - Research Medical Center
  - Kansas City, Missouri, Forenede Stater, 64108
    - Truman Medical Centers
  - Kansas City, Missouri, Forenede Stater, 64118
    - Heartland Hematology and Oncology Associates Incorporated
  - Lee's Summit, Missouri, Forenede Stater, 64064
    - University of Kansas Cancer Center - Lee's Summit
  - Lee's Summit, Missouri, Forenede Stater, 64086
    - Saint Luke's East - Lee's Summit
  - Liberty, Missouri, Forenede Stater, 64068
    - Liberty Radiation Oncology Center
  - Rolla, Missouri, Forenede Stater, 65401
    - Delbert Day Cancer Institute at PCRMC
  - Rolla, Missouri, Forenede Stater, 65401
    - Mercy Clinic-Rolla-Cancer and Hematology
  - Saint Joseph, Missouri, Forenede Stater, 64506
    - Heartland Regional Medical Center
  - Saint Louis, Missouri, Forenede Stater, 63110
    - Washington University School of Medicine
  - Saint Louis, Missouri, Forenede Stater, 63131
    - Missouri Baptist Medical Center
  - Saint Louis, Missouri, Forenede Stater, 63141
    - Mercy Hospital Saint Louis
  - Saint Louis, Missouri, Forenede Stater, 63109
    - Saint Louis Cancer and Breast Institute-South City
  - Saint Louis, Missouri, Forenede Stater, 63141
    - Saint Louis-Cape Girardeau CCOP
  - Sainte Genevieve, Missouri, Forenede Stater, 63670
    - Sainte Genevieve County Memorial Hospital
  - Springfield, Missouri, Forenede Stater, 65804
    - Cancer Research for the Ozarks NCORP
  - Springfield, Missouri, Forenede Stater, 65807
    - CoxHealth South Hospital
  - Springfield, Missouri, Forenede Stater, 65804
    - Mercy Hospital Springfield
  - Sullivan, Missouri, Forenede Stater, 63080
    - Missouri Baptist Sullivan Hospital
  - Sunset Hills, Missouri, Forenede Stater, 63127
    - BJC Outpatient Center at Sunset Hills
- Montana
  - Billings, Montana, Forenede Stater, 59101
    - Billings Clinic Cancer Center
  - Billings, Montana, Forenede Stater, 59101
    - Saint Vincent Healthcare
  - Billings, Montana, Forenede Stater, 59102
    - Montana Cancer Consortium NCORP
  - Bozeman, Montana, Forenede Stater, 59715
    - Bozeman Deaconess Hospital
  - Butte, Montana, Forenede Stater, 59701
    - Saint James Community Hospital and Cancer Treatment Center
  - Great Falls, Montana, Forenede Stater, 59405
    - Benefis Healthcare- Sletten Cancer Institute
  - Helena, Montana, Forenede Stater, 59601
    - Saint Peter's Community Hospital
  - Kalispell, Montana, Forenede Stater, 59901
    - Kalispell Regional Medical Center
  - Missoula, Montana, Forenede Stater, 59802
    - Saint Patrick Hospital - Community Hospital
- Nebraska
  - Grand Island, Nebraska, Forenede Stater, 68803
    - CHI Health Saint Francis
  - Kearney, Nebraska, Forenede Stater, 68847
    - CHI Health Good Samaritan
  - Kearney, Nebraska, Forenede Stater, 68845
    - Heartland Hematology and Oncology
  - Lincoln, Nebraska, Forenede Stater, 68506
    - Nebraska Hematology and Oncology
  - Lincoln, Nebraska, Forenede Stater, 68510
    - Nebraska Cancer Research Center
  - Lincoln, Nebraska, Forenede Stater, 68516
    - Southeast Nebraska Cancer Center - 68th Street Place
  - Lincoln, Nebraska, Forenede Stater, 68510
    - Saint Elizabeth Regional Medical Center
  - Omaha, Nebraska, Forenede Stater, 68114
    - Nebraska Methodist Hospital
  - Omaha, Nebraska, Forenede Stater, 68198
    - University Of Nebraska Medical Center
  - Omaha, Nebraska, Forenede Stater, 68124
    - Alegent Health Bergan Mercy Medical Center
  - Omaha, Nebraska, Forenede Stater, 68122
    - Alegent Health Immanuel Medical Center
  - Omaha, Nebraska, Forenede Stater, 68130
    - Alegent Health Lakeside Hospital
  - Omaha, Nebraska, Forenede Stater, 68131
    - Creighton University Medical Center
  - Omaha, Nebraska, Forenede Stater, 68106
    - Missouri Valley Cancer Consortium
  - Omaha, Nebraska, Forenede Stater, 68124
    - Nebraska Cancer Specialists - Omaha
  - Omaha, Nebraska, Forenede Stater, 68122
    - Hematology and Oncology Consultants PC
  - Papillion, Nebraska, Forenede Stater, 68046
    - Midlands Community Hospital
  - Scottsbluff, Nebraska, Forenede Stater, 69361
    - Regional West Medical Center Cancer Center
- Nevada
  - Henderson, Nevada, Forenede Stater, 89052
    - Comprehensive Cancer Centers of Nevada - Henderson
  - Henderson, Nevada, Forenede Stater, 89052
    - Cancer and Blood Specialists-Henderson
  - Henderson, Nevada, Forenede Stater, 89052
    - Las Vegas Cancer Center-Henderson
  - Henderson, Nevada, Forenede Stater, 89074
    - Comprehensive Cancer Centers of Nevada-Southeast Henderson
  - Henderson, Nevada, Forenede Stater, 89074
    - GenesisCare USA - Henderson
  - Las Vegas, Nevada, Forenede Stater, 89144
    - Summerlin Hospital Medical Center
  - Las Vegas, Nevada, Forenede Stater, 89106
    - Radiation Oncology Centers of Nevada Central
  - Las Vegas, Nevada, Forenede Stater, 89109
    - GenesisCare USA - Las Vegas
  - Las Vegas, Nevada, Forenede Stater, 89119
    - Radiation Oncology Centers of Nevada Southeast
  - Las Vegas, Nevada, Forenede Stater, 89128
    - Comprehensive Cancer Centers of Nevada - Northwest
  - Las Vegas, Nevada, Forenede Stater, 89135
    - Alliance for Childhood Diseases/Cure 4 the Kids Foundation
  - Las Vegas, Nevada, Forenede Stater, 89144
    - Comprehensive Cancer Centers of Nevada-Summerlin
  - Las Vegas, Nevada, Forenede Stater, 89148
    - Comprehensive Cancer Centers of Nevada
  - Las Vegas, Nevada, Forenede Stater, 89148
    - OptumCare Cancer Care at Fort Apache
  - Las Vegas, Nevada, Forenede Stater, 89169
    - Comprehensive Cancer Centers of Nevada - Central Valley
  - Las Vegas, Nevada, Forenede Stater, 89102
    - University Medical Center of Southern Nevada
  - Las Vegas, Nevada, Forenede Stater, 89106
    - Cancer and Blood Specialists-Shadow
  - Las Vegas, Nevada, Forenede Stater, 89109
    - HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
  - Las Vegas, Nevada, Forenede Stater, 89113
    - HealthCare Partners Medical Group Oncology/Hematology-San Martin
  - Las Vegas, Nevada, Forenede Stater, 89121
    - Cancer Therapy and Integrative Medicine
  - Las Vegas, Nevada, Forenede Stater, 89128
    - Cancer and Blood Specialists-Tenaya
  - Las Vegas, Nevada, Forenede Stater, 89128
    - GenesisCare USA - Vegas Tenaya
  - Las Vegas, Nevada, Forenede Stater, 89128
    - HealthCare Partners Medical Group Oncology/Hematology-Tenaya
  - Las Vegas, Nevada, Forenede Stater, 89148-2405
    - Las Vegas Cancer Center-Medical Center
  - Las Vegas, Nevada, Forenede Stater, 89148
    - GenesisCare USA - Fort Apache
  - Las Vegas, Nevada, Forenede Stater, 89149
    - HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
  - Las Vegas, Nevada, Forenede Stater, 89169
    - Nevada Cancer Research Foundation NCORP
  - Reno, Nevada, Forenede Stater, 89502
    - Renown Regional Medical Center
- New Hampshire
  - Lebanon, New Hampshire, Forenede Stater, 03756
    - Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
  - Portsmouth, New Hampshire, Forenede Stater, 03802
    - Portsmouth Regional Hospital
- New Jersey
  - Camden, New Jersey, Forenede Stater, 08103
    - Cooper Hospital University Medical Center
  - East Orange, New Jersey, Forenede Stater, 07018-1095
    - Veterans Adminstration New Jersey Health Care System
  - Flemington, New Jersey, Forenede Stater, 08822
    - Hunterdon Medical Center
  - Hackensack, New Jersey, Forenede Stater, 07601
    - Hackensack University Medical Center
  - Hamilton, New Jersey, Forenede Stater, 08690
    - The Cancer Institute of New Jersey Hamilton
  - Livingston, New Jersey, Forenede Stater, 07039
    - Saint Barnabas Medical Center
  - Morristown, New Jersey, Forenede Stater, 07960
    - Morristown Medical Center
  - New Brunswick, New Jersey, Forenede Stater, 08903
    - Rutgers Cancer Institute of New Jersey
  - Summit, New Jersey, Forenede Stater, 07902
    - Overlook Hospital
  - Vineland, New Jersey, Forenede Stater, 08360
    - Inspira Medical Center Vineland
  - Voorhees, New Jersey, Forenede Stater, 08043
    - MD Anderson Cancer Center at Cooper-Voorhees
- New Mexico
  - Albuquerque, New Mexico, Forenede Stater, 87102
    - University of New Mexico Cancer Center
  - Albuquerque, New Mexico, Forenede Stater, 87110
    - Presbyterian Kaseman Hospital
- New York
  - Albany, New York, Forenede Stater, 12206
    - New York Oncology Hematology PC - Albany
  - Albany, New York, Forenede Stater, 12208
    - New York Oncology Hematology PC - Albany Medical Center
  - Amsterdam, New York, Forenede Stater, 12010
    - New York Oncology Hematology PC - Amsterdam
  - Auburn, New York, Forenede Stater, 13021
    - Hematology Oncology Associates of Central New York-Auburn
  - Bronx, New York, Forenede Stater, 10467
    - Montefiore Medical Center - Moses Campus
  - Bronx, New York, Forenede Stater, 10461
    - Montefiore Medical Center-Weiler Hospital
  - Clifton Park, New York, Forenede Stater, 12065
    - New York Oncology Hematology PC - Clifton Park
  - Cooperstown, New York, Forenede Stater, 13326
    - Mary Imogene Bassett Hospital
  - East Syracuse, New York, Forenede Stater, 13057
    - Hematology Oncology Associates of Central New York-East Syracuse
  - Glens Falls, New York, Forenede Stater, 12801
    - Glens Falls Hospital
  - Hudson, New York, Forenede Stater, 12534
    - New York Oncology Hematology PC-Hudson
  - Lake Success, New York, Forenede Stater, 11042
    - Northwell Health NCORP
  - Lake Success, New York, Forenede Stater, 11042
    - Northwell Health/Center for Advanced Medicine
  - Liverpool, New York, Forenede Stater, 13088
    - Hematology Oncology Associates of Central New York-Liverpool
  - Manhasset, New York, Forenede Stater, 11030
    - North Shore University Hospital
  - Middletown, New York, Forenede Stater, 10940
    - Garnet Health Medical Center
  - New Hyde Park, New York, Forenede Stater, 11040
    - Long Island Jewish Medical Center
  - New York, New York, Forenede Stater, 10019
    - Mount Sinai West
  - New York, New York, Forenede Stater, 10032
    - NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
  - New York, New York, Forenede Stater, 10003
    - Mount Sinai Union Square
  - Poughkeepsie, New York, Forenede Stater, 12601
    - MidHudson Regional Hospital of Westchester Medical Center
  - Rochester, New York, Forenede Stater, 14642
    - University of Rochester
  - Rome, New York, Forenede Stater, 13440
    - Hematology Oncology Associates of Central New York-Rome
  - Stony Brook, New York, Forenede Stater, 11794
    - Stony Brook University Medical Center
  - Syracuse, New York, Forenede Stater, 13210
    - State University of New York Upstate Medical University
  - Syracuse, New York, Forenede Stater, 13215
    - Hematology Oncology Associates of Central New York-Onondaga Hill
  - Troy, New York, Forenede Stater, 12180
    - New York Oncology Hematology PC - Troy
  - Utica, New York, Forenede Stater, 13502
    - Faxton-Saint Luke's Healthcare
- North Carolina
  - Albemarle, North Carolina, Forenede Stater, 28002
    - Atrium Health Stanly/LCI-Albemarle
  - Asheboro, North Carolina, Forenede Stater, 27203
    - Randolph Hospital
  - Asheville, North Carolina, Forenede Stater, 28801
    - Mission Hospital
  - Asheville, North Carolina, Forenede Stater, 28816
    - Hope Women's Cancer Centers-Asheville
  - Asheville, North Carolina, Forenede Stater, 28806
    - Messino Cancer Centers
  - Asheville, North Carolina, Forenede Stater, 28801
    - Mountain Radiation Oncology PA
  - Asheville, North Carolina, Forenede Stater, 28803
    - AdventHealth Infusion Center Asheville
  - Brevard, North Carolina, Forenede Stater, 28712
    - Transylvania Regional Hospital
  - Chapel Hill, North Carolina, Forenede Stater, 27599
    - UNC Lineberger Comprehensive Cancer Center
  - Charlotte, North Carolina, Forenede Stater, 28203
    - Carolinas Medical Center/Levine Cancer Institute
  - Charlotte, North Carolina, Forenede Stater, 28204
    - Novant Health Presbyterian Medical Center
  - Clinton, North Carolina, Forenede Stater, 28328
    - Southeastern Medical Oncology Center-Clinton
  - Clinton, North Carolina, Forenede Stater, 28328
    - Sampson Radiation Oncology
  - Concord, North Carolina, Forenede Stater, 28025
    - Atrium Health Cabarrus/LCI-Concord
  - Durham, North Carolina, Forenede Stater, 27710
    - Duke University Medical Center
  - Franklin, North Carolina, Forenede Stater, 28734
    - Angel Medical Center
  - Goldsboro, North Carolina, Forenede Stater, 27534
    - Southeastern Medical Oncology Center-Goldsboro
  - Goldsboro, North Carolina, Forenede Stater, 27534
    - Wayne Memorial Hospital
  - Goldsboro, North Carolina, Forenede Stater, 27534
    - Wayne Radiation Oncology
  - Greensboro, North Carolina, Forenede Stater, 27403
    - Cone Health Cancer Center
  - Greenville, North Carolina, Forenede Stater, 27834
    - East Carolina University
  - Jacksonville, North Carolina, Forenede Stater, 28546
    - Southeastern Medical Oncology Center-Jacksonville
  - Jacksonville, North Carolina, Forenede Stater, 28546
    - Onslow Memorial Hospital
  - Kinston, North Carolina, Forenede Stater, 28501
    - Vidant Oncology-Kinston
  - Marion, North Carolina, Forenede Stater, 28752
    - Mission Hospital McDowell
  - Monroe, North Carolina, Forenede Stater, 28112
    - Atrium Health Union/LCI-Union
  - Reidsville, North Carolina, Forenede Stater, 27320
    - Annie Penn Memorial Hospital
  - Rutherfordton, North Carolina, Forenede Stater, 28139
    - Rutherford Hospital
  - Spruce Pine, North Carolina, Forenede Stater, 28777
    - Blue Ridge Regional Hospital
  - Statesville, North Carolina, Forenede Stater, 28677
    - Iredell Memorial Hospital
  - Winston-Salem, North Carolina, Forenede Stater, 27157
    - Wake Forest University Health Sciences
  - Winston-Salem, North Carolina, Forenede Stater, 27104
    - Southeast Clinical Oncology Research Consortium NCORP
- North Dakota
  - Bismarck, North Dakota, Forenede Stater, 58501
    - Sanford Bismarck Medical Center
  - Bismarck, North Dakota, Forenede Stater, 58501
    - Mid Dakota Clinic
  - Bismarck, North Dakota, Forenede Stater, 58501
    - Saint Alexius Medical Center
  - Fargo, North Dakota, Forenede Stater, 58122
    - Sanford Roger Maris Cancer Center
  - Fargo, North Dakota, Forenede Stater, 58122
    - Sanford Broadway Medical Center
  - Fargo, North Dakota, Forenede Stater, 58122
    - Sanford Clinic North-Fargo
  - Grand Forks, North Dakota, Forenede Stater, 58201
    - Altru Cancer Center
  - Minot, North Dakota, Forenede Stater, 58701
    - Trinity Cancer Care Center
- Ohio
  - Akron, Ohio, Forenede Stater, 44307
    - Cleveland Clinic Akron General
  - Akron, Ohio, Forenede Stater, 44304
    - Summa Health System - Akron Campus
  - Barberton, Ohio, Forenede Stater, 44203
    - Summa Health System - Barberton Campus
  - Beachwood, Ohio, Forenede Stater, 44122
    - Cleveland Clinic Cancer Center Beachwood
  - Bellefontaine, Ohio, Forenede Stater, 43311
    - Mary Rutan Hospital
  - Belpre, Ohio, Forenede Stater, 45714
    - Strecker Cancer Center-Belpre
  - Bowling Green, Ohio, Forenede Stater, 43402
    - Toledo Clinic Cancer Centers-Bowling Green
  - Canton, Ohio, Forenede Stater, 44710
    - Aultman Health Foundation
  - Centerville, Ohio, Forenede Stater, 45459
    - Miami Valley Hospital South
  - Chillicothe, Ohio, Forenede Stater, 45601
    - Adena Regional Medical Center
  - Cincinnati, Ohio, Forenede Stater, 45219
    - The Christ Hospital
  - Cincinnati, Ohio, Forenede Stater, 45219
    - University of Cincinnati Cancer Center-UC Medical Center
  - Cincinnati, Ohio, Forenede Stater, 45220
    - Good Samaritan Hospital - Cincinnati
  - Cincinnati, Ohio, Forenede Stater, 45242
    - Bethesda North Hospital
  - Cincinnati, Ohio, Forenede Stater, 45242
    - Oncology Hematology Care Inc-Blue Ash
  - Cincinnati, Ohio, Forenede Stater, 45202
    - Oncology Hematology Care Inc-Eden Park
  - Cincinnati, Ohio, Forenede Stater, 45211
    - Oncology Hematology Care Inc-Mercy West
  - Cincinnati, Ohio, Forenede Stater, 45230
    - Oncology Hematology Care Inc-Anderson
  - Cincinnati, Ohio, Forenede Stater, 45236
    - Oncology Hematology Care Inc-Kenwood
  - Cleveland, Ohio, Forenede Stater, 44106
    - Case Western Reserve University
  - Cleveland, Ohio, Forenede Stater, 44109
    - MetroHealth Medical Center
  - Cleveland, Ohio, Forenede Stater, 44195
    - Cleveland Clinic Foundation
  - Cleveland, Ohio, Forenede Stater, 44111
    - Cleveland Clinic Cancer Center/Fairview Hospital
  - Columbus, Ohio, Forenede Stater, 43214
    - Riverside Methodist Hospital
  - Columbus, Ohio, Forenede Stater, 43210
    - Ohio State University Comprehensive Cancer Center
  - Columbus, Ohio, Forenede Stater, 43219
    - The Mark H Zangmeister Center
  - Columbus, Ohio, Forenede Stater, 43214
    - Columbus Oncology and Hematology Associates Inc
  - Columbus, Ohio, Forenede Stater, 43228
    - Doctors Hospital
  - Columbus, Ohio, Forenede Stater, 43215
    - Grant Medical Center
  - Columbus, Ohio, Forenede Stater, 43222
    - Mount Carmel Health Center West
  - Columbus, Ohio, Forenede Stater, 43215
    - Columbus NCI Community Oncology Research Program
  - Dayton, Ohio, Forenede Stater, 45406
    - Good Samaritan Hospital - Dayton
  - Dayton, Ohio, Forenede Stater, 45409
    - Miami Valley Hospital
  - Dayton, Ohio, Forenede Stater, 45415
    - Miami Valley Hospital North
  - Dayton, Ohio, Forenede Stater, 45405
    - Grandview Hospital
  - Dayton, Ohio, Forenede Stater, 45459
    - Dayton NCI Community Oncology Research Program
  - Delaware, Ohio, Forenede Stater, 43015
    - Delaware Health Center-Grady Cancer Center
  - Delaware, Ohio, Forenede Stater, 43015
    - Delaware Radiation Oncology
  - Delaware, Ohio, Forenede Stater, 43015
    - Grady Memorial Hospital
  - Fairfield, Ohio, Forenede Stater, 45014
    - Oncology Hematology Care Inc-Healthplex
  - Findlay, Ohio, Forenede Stater, 45840
    - Blanchard Valley Hospital
  - Franklin, Ohio, Forenede Stater, 45005-1066
    - Atrium Medical Center-Middletown Regional Hospital
  - Greenville, Ohio, Forenede Stater, 45331
    - Wayne Hospital
  - Independence, Ohio, Forenede Stater, 44131
    - Cleveland Clinic Cancer Center Independence
  - Kettering, Ohio, Forenede Stater, 45429
    - Kettering Medical Center
  - Lancaster, Ohio, Forenede Stater, 43130
    - Fairfield Medical Center
  - Lancaster, Ohio, Forenede Stater, 43130
    - Lancaster Radiation Oncology
  - Lima, Ohio, Forenede Stater, 45804
    - Lima Memorial Hospital
  - Marietta, Ohio, Forenede Stater, 45750
    - Marietta Memorial Hospital
  - Maumee, Ohio, Forenede Stater, 43537
    - Toledo Clinic Cancer Centers-Maumee
  - Maumee, Ohio, Forenede Stater, 43537
    - Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
  - Mayfield Heights, Ohio, Forenede Stater, 44124
    - Hillcrest Hospital Cancer Center
  - Mount Vernon, Ohio, Forenede Stater, 43050
    - Knox Community Hospital
  - Newark, Ohio, Forenede Stater, 43055
    - Licking Memorial Hospital
  - Newark, Ohio, Forenede Stater, 43055
    - Newark Radiation Oncology
  - Oregon, Ohio, Forenede Stater, 43616
    - Saint Charles Hospital
  - Oregon, Ohio, Forenede Stater, 43616
    - Toledo Clinic Cancer Centers-Oregon
  - Portsmouth, Ohio, Forenede Stater, 45662
    - Southern Ohio Medical Center
  - Sandusky, Ohio, Forenede Stater, 44870
    - North Coast Cancer Care
  - Springfield, Ohio, Forenede Stater, 45505
    - Springfield Regional Medical Center
  - Strongsville, Ohio, Forenede Stater, 44136
    - Cleveland Clinic Cancer Center Strongsville
  - Sylvania, Ohio, Forenede Stater, 43560
    - ProMedica Flower Hospital
  - Tiffin, Ohio, Forenede Stater, 44883
    - Mercy Hospital of Tiffin
  - Toledo, Ohio, Forenede Stater, 43606
    - ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
  - Toledo, Ohio, Forenede Stater, 43608
    - Saint Vincent Mercy Medical Center
  - Toledo, Ohio, Forenede Stater, 43623
    - Mercy Health - Saint Anne Hospital
  - Toledo, Ohio, Forenede Stater, 43623
    - Toledo Clinic Cancer Centers-Toledo
  - Toledo, Ohio, Forenede Stater, 43614
    - University of Toledo
  - Toledo, Ohio, Forenede Stater, 43617
    - Toledo Community Hospital Oncology Program CCOP
  - Troy, Ohio, Forenede Stater, 45373
    - Upper Valley Medical Center
  - Wauseon, Ohio, Forenede Stater, 43567
    - Fulton County Health Center
  - Westerville, Ohio, Forenede Stater, 43081
    - Saint Ann's Hospital
  - Wooster, Ohio, Forenede Stater, 44691
    - Cleveland Clinic Wooster Family Health and Surgery Center
  - Wright-Patterson Air Force Base, Ohio, Forenede Stater, 45433
    - Wright-Patterson Medical Center
  - Xenia, Ohio, Forenede Stater, 45385
    - Greene Memorial Hospital
  - Zanesville, Ohio, Forenede Stater, 43701
    - Genesis Healthcare System Cancer Care Center
- Oklahoma
  - Lawton, Oklahoma, Forenede Stater, 73505
    - Cancer Centers of Southwest Oklahoma Research
  - Norman, Oklahoma, Forenede Stater, 73071
    - Cancer Care Associates-Norman
  - Oklahoma City, Oklahoma, Forenede Stater, 73104
    - University of Oklahoma Health Sciences Center
  - Oklahoma City, Oklahoma, Forenede Stater, 73120
    - Mercy Hospital Oklahoma City
  - Oklahoma City, Oklahoma, Forenede Stater, 73109
    - Integris Southwest Medical Center
  - Oklahoma City, Oklahoma, Forenede Stater, 73120
    - Mercy Physicians of Oklahoma-Lakeside
  - Oklahoma City, Oklahoma, Forenede Stater, 73142
    - Integris Cancer Institute of Oklahoma
  - Tulsa, Oklahoma, Forenede Stater, 74146
    - Oklahoma Cancer Specialists and Research Institute-Tulsa
- Oregon
  - Bend, Oregon, Forenede Stater, 97701
    - Saint Charles Health System
  - Clackamas, Oregon, Forenede Stater, 97015
    - Clackamas Radiation Oncology Center
  - Clackamas, Oregon, Forenede Stater, 97015
    - Providence Cancer Institute Clackamas Clinic
  - Coos Bay, Oregon, Forenede Stater, 97420
    - Bay Area Hospital
  - Milwaukie, Oregon, Forenede Stater, 97222
    - Providence Milwaukie Hospital
  - Newberg, Oregon, Forenede Stater, 97132
    - Providence Newberg Medical Center
  - Oregon City, Oregon, Forenede Stater, 97045
    - Providence Willamette Falls Medical Center
  - Portland, Oregon, Forenede Stater, 97239
    - Oregon Health and Science University
  - Portland, Oregon, Forenede Stater, 97213
    - Providence Portland Medical Center
  - Portland, Oregon, Forenede Stater, 97225
    - Providence Saint Vincent Medical Center
  - Portland, Oregon, Forenede Stater, 97227
    - Kaiser Permanente Northwest
  - The Dalles, Oregon, Forenede Stater, 97058
    - Mid-Columbia Medical Center/Celilo Cancer Center
- Pennsylvania
  - Abington, Pennsylvania, Forenede Stater, 19001
    - Jefferson Abington Hospital
  - Allentown, Pennsylvania, Forenede Stater, 18103
    - Lehigh Valley Hospital-Cedar Crest
  - Bethlehem, Pennsylvania, Forenede Stater, 18017
    - Lehigh Valley Hospital - Muhlenberg
  - Bethlehem, Pennsylvania, Forenede Stater, 18015
    - Saint Luke's University Hospital-Bethlehem Campus
  - Bryn Mawr, Pennsylvania, Forenede Stater, 19010
    - Bryn Mawr Hospital
  - Danville, Pennsylvania, Forenede Stater, 17822
    - Geisinger Medical Center
  - Drexel Hill, Pennsylvania, Forenede Stater, 19026
    - Delaware County Memorial Hospital
  - East Stroudsburg, Pennsylvania, Forenede Stater, 18301
    - Pocono Medical Center
  - Hazleton, Pennsylvania, Forenede Stater, 18201
    - Geisinger Medical Center-Cancer Center Hazleton
  - Hershey, Pennsylvania, Forenede Stater, 17033-0850
    - Penn State Milton S Hershey Medical Center
  - Kittanning, Pennsylvania, Forenede Stater, 16201
    - Armstrong Center for Medicine and Health
  - Lewisburg, Pennsylvania, Forenede Stater, 17837
    - Geisinger Medical Oncology-Lewisburg
  - Lewistown, Pennsylvania, Forenede Stater, 17044
    - Lewistown Hospital
  - Media, Pennsylvania, Forenede Stater, 19063
    - Riddle Memorial Hospital
  - Monroeville, Pennsylvania, Forenede Stater, 15146
    - Forbes Hospital
  - Natrona Heights, Pennsylvania, Forenede Stater, 15065
    - Allegheny Valley Hospital
  - Paoli, Pennsylvania, Forenede Stater, 19301
    - Paoli Memorial Hospital
  - Philadelphia, Pennsylvania, Forenede Stater, 19111
    - Fox Chase Cancer Center
  - Philadelphia, Pennsylvania, Forenede Stater, 19107
    - Thomas Jefferson University Hospital
  - Philadelphia, Pennsylvania, Forenede Stater, 19104
    - University of Pennsylvania/Abramson Cancer Center
  - Pittsburgh, Pennsylvania, Forenede Stater, 15212
    - Allegheny General Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15224
    - West Penn Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15232
    - University of Pittsburgh Cancer Institute (UPCI)
  - Pottsville, Pennsylvania, Forenede Stater, 17901
    - Geisinger Cancer Services-Pottsville
  - Sayre, Pennsylvania, Forenede Stater, 18840
    - Guthrie Medical Group PC-Robert Packer Hospital
  - Scranton, Pennsylvania, Forenede Stater, 18510
    - Scranton Hematology Oncology
  - Scranton, Pennsylvania, Forenede Stater, 18501
    - Mercy Hospital
  - State College, Pennsylvania, Forenede Stater, 16801
    - Geisinger Medical Group
  - State College, Pennsylvania, Forenede Stater, 16803
    - Mount Nittany Medical Center
  - West Reading, Pennsylvania, Forenede Stater, 19611
    - Reading Hospital
  - Wilkes-Barre, Pennsylvania, Forenede Stater, 18711
    - Geisinger Wyoming Valley/Henry Cancer Center
  - Williamsport, Pennsylvania, Forenede Stater, 17701
    - UPMC Susquehanna
  - Wynnewood, Pennsylvania, Forenede Stater, 19096
    - Lankenau Medical Center
  - Wynnewood, Pennsylvania, Forenede Stater, 19096
    - Main Line Health NCORP
- Rhode Island
  - Providence, Rhode Island, Forenede Stater, 02903
    - Rhode Island Hospital
  - Providence, Rhode Island, Forenede Stater, 02906
    - Miriam Hospital
  - Providence, Rhode Island, Forenede Stater, 02908
    - Roger Williams Medical Center
- South Carolina
  - Anderson, South Carolina, Forenede Stater, 29621
    - AnMed Health Cancer Center
  - Anderson, South Carolina, Forenede Stater, 29621
    - AnMed Health Hospital
  - Boiling Springs, South Carolina, Forenede Stater, 29316
    - Prisma Health Cancer Institute - Spartanburg
  - Charleston, South Carolina, Forenede Stater, 29401
    - Roper Hospital
  - Charleston, South Carolina, Forenede Stater, 29414
    - Lowcountry Hematology Oncology PA-West Ashley
  - Charleston, South Carolina, Forenede Stater, 29403
    - Charleston Oncology - Roper
  - Charleston, South Carolina, Forenede Stater, 29414
    - Charleston Oncology - Saint Francis
  - Easley, South Carolina, Forenede Stater, 29640
    - Prisma Health Cancer Institute - Easley
  - Greenville, South Carolina, Forenede Stater, 29605
    - Prisma Health Cancer Institute - Faris
  - Greenville, South Carolina, Forenede Stater, 29615
    - Prisma Health Cancer Institute - Eastside
  - Greenville, South Carolina, Forenede Stater, 29605
    - Prisma Health Cancer Institute - Butternut
  - Greenville, South Carolina, Forenede Stater, 29601
    - Saint Francis Hospital
  - Greenville, South Carolina, Forenede Stater, 29605
    - Prisma Health Greenville Memorial Hospital
  - Greer, South Carolina, Forenede Stater, 29650
    - Prisma Health Cancer Institute - Greer
  - Greer, South Carolina, Forenede Stater, 29651
    - Gibbs Cancer Center-Pelham
  - Lancaster, South Carolina, Forenede Stater, 29720
    - Carolina Blood and Cancer Care Associates PA-Lancaster
  - Mount Pleasant, South Carolina, Forenede Stater, 29464
    - Lowcountry Hematology Oncology PA-Mount Pleasant
  - Rock Hill, South Carolina, Forenede Stater, 29732
    - Carolina Blood and Cancer Care Associates PA
  - Seneca, South Carolina, Forenede Stater, 29672
    - Prisma Health Cancer Institute - Seneca
  - Spartanburg, South Carolina, Forenede Stater, 29303
    - Spartanburg Medical Center
- South Dakota
  - Sioux Falls, South Dakota, Forenede Stater, 57105
    - Avera Cancer Institute
  - Sioux Falls, South Dakota, Forenede Stater, 57117-5134
    - Sanford USD Medical Center - Sioux Falls
  - Sioux Falls, South Dakota, Forenede Stater, 57104
    - Sanford Cancer Center Oncology Clinic
  - Sioux Falls, South Dakota, Forenede Stater, 57117-5045
    - Avera McKennan Hospital and University Health Center
- Tennessee
  - Chattanooga, Tennessee, Forenede Stater, 37404
    - Memorial Hospital
  - Chattanooga, Tennessee, Forenede Stater, 37403
    - Erlanger Medical Center
  - Jackson, Tennessee, Forenede Stater, 38301
    - Jackson-Madison County General Hospital
  - Kingsport, Tennessee, Forenede Stater, 37660
    - Ballad Health Cancer Care - Kingsport
  - Kingsport, Tennessee, Forenede Stater, 37660
    - Wellmont Holston Valley Hospital and Medical Center
  - Knoxville, Tennessee, Forenede Stater, 37916
    - Thompson Cancer Survival Center
  - Knoxville, Tennessee, Forenede Stater, 37920
    - University of Tennessee - Knoxville
  - Nashville, Tennessee, Forenede Stater, 37232
    - Vanderbilt University/Ingram Cancer Center
- Texas
  - Dallas, Texas, Forenede Stater, 75235
    - Parkland Memorial Hospital
  - Dallas, Texas, Forenede Stater, 75390
    - UT Southwestern/Simmons Cancer Center-Dallas
  - Dallas, Texas, Forenede Stater, 75246
    - Baylor University Medical Center
  - Fort Sam Houston, Texas, Forenede Stater, 78234
    - Brooke Army Medical Center
  - Temple, Texas, Forenede Stater, 76508
    - Scott and White Memorial Hospital
- Utah
  - American Fork, Utah, Forenede Stater, 84003
    - American Fork Hospital / Huntsman Intermountain Cancer Center
  - Cedar City, Utah, Forenede Stater, 84720
    - Sandra L Maxwell Cancer Center
  - Logan, Utah, Forenede Stater, 84321
    - Logan Regional Hospital
  - Murray, Utah, Forenede Stater, 84107
    - Intermountain Medical Center
  - Ogden, Utah, Forenede Stater, 84403
    - McKay-Dee Hospital Center
  - Provo, Utah, Forenede Stater, 84604
    - Utah Valley Regional Medical Center
  - Saint George, Utah, Forenede Stater, 84770
    - Saint George Regional Medical Center
  - Salt Lake City, Utah, Forenede Stater, 84112
    - Huntsman Cancer Institute/University of Utah
  - Salt Lake City, Utah, Forenede Stater, 84106
    - Utah Cancer Specialists-Salt Lake City
  - Salt Lake City, Utah, Forenede Stater, 84143
    - LDS Hospital
- Vermont
  - Berlin, Vermont, Forenede Stater, 05602
    - Central Vermont Medical Center/National Life Cancer Treatment
  - Burlington, Vermont, Forenede Stater, 05405
    - University of Vermont and State Agricultural College
- Virginia
  - Fredericksburg, Virginia, Forenede Stater, 22401
    - Fredericksburg Oncology Inc
  - Fredericksburg, Virginia, Forenede Stater, 22408
    - Hematology Oncology Associates of Fredericksburg Inc
  - Norton, Virginia, Forenede Stater, 24273
    - Southwest VA Regional Cancer Center
  - Richmond, Virginia, Forenede Stater, 23298
    - Virginia Commonwealth University/Massey Cancer Center
- Washington
  - Anacortes, Washington, Forenede Stater, 98221
    - Cancer Care Center at Island Hospital
  - Auburn, Washington, Forenede Stater, 98001
    - MultiCare Auburn Medical Center
  - Bellevue, Washington, Forenede Stater, 98004
    - Overlake Medical Center
  - Bellingham, Washington, Forenede Stater, 98225
    - PeaceHealth Saint Joseph Medical Center
  - Bremerton, Washington, Forenede Stater, 98310
    - Harrison HealthPartners Hematology and Oncology-Bremerton
  - Bremerton, Washington, Forenede Stater, 98310
    - Harrison Medical Center
  - Burien, Washington, Forenede Stater, 98166
    - Highline Medical Center-Main Campus
  - Centralia, Washington, Forenede Stater, 98531
    - Providence Regional Cancer System-Centralia
  - Edmonds, Washington, Forenede Stater, 98026
    - Swedish Cancer Institute-Edmonds
  - Everett, Washington, Forenede Stater, 98201
    - Providence Regional Cancer Partnership
  - Federal Way, Washington, Forenede Stater, 98003
    - Saint Francis Hospital
  - Issaquah, Washington, Forenede Stater, 98029
    - Swedish Cancer Institute-Issaquah
  - Kennewick, Washington, Forenede Stater, 99336
    - Kadlec Clinic Hematology and Oncology
  - Kirkland, Washington, Forenede Stater, 98034
    - Seattle Cancer Care Alliance at EvergreenHealth
  - Lacey, Washington, Forenede Stater, 98503
    - Providence Regional Cancer System-Lacey
  - Lakewood, Washington, Forenede Stater, 98499
    - Saint Clare Hospital
  - Longview, Washington, Forenede Stater, 98632
    - PeaceHealth Saint John Medical Center
  - Mount Vernon, Washington, Forenede Stater, 98274
    - Skagit Valley Hospital
  - Olympia, Washington, Forenede Stater, 98506-5166
    - Providence - Saint Peter Hospital
  - Olympia, Washington, Forenede Stater, 98507
    - Capital Medical Center
  - Poulsbo, Washington, Forenede Stater, 98370
    - Harrison HealthPartners Hematology and Oncology-Poulsbo
  - Puyallup, Washington, Forenede Stater, 98372
    - MultiCare Good Samaritan Hospital
  - Seattle, Washington, Forenede Stater, 98109
    - Fred Hutchinson Cancer Research Center
  - Seattle, Washington, Forenede Stater, 98101
    - Virginia Mason Medical Center
  - Seattle, Washington, Forenede Stater, 98107
    - Swedish Medical Center-Ballard Campus
  - Seattle, Washington, Forenede Stater, 98122
    - Swedish Medical Center-First Hill
  - Seattle, Washington, Forenede Stater, 98195
    - University of Washington Medical Center - Montlake
  - Seattle, Washington, Forenede Stater, 98112
    - Kaiser Permanente Washington
  - Seattle, Washington, Forenede Stater, 98104
    - Minor and James Medical PLLC
  - Seattle, Washington, Forenede Stater, 98104
    - Pacific Medical Center-First Hill
  - Spokane, Washington, Forenede Stater, 99218
    - Evergreen Hematology and Oncology PS
  - Spokane, Washington, Forenede Stater, 99202
    - Cancer Care Northwest - Spokane South
  - Spokane, Washington, Forenede Stater, 99220
    - Rockwood Clinic
  - Tacoma, Washington, Forenede Stater, 98405
    - Northwest Medical Specialties PLLC
  - Tacoma, Washington, Forenede Stater, 98405
    - MultiCare Tacoma General Hospital
  - Tacoma, Washington, Forenede Stater, 98405
    - MultiCare Allenmore Hospital
  - Tacoma, Washington, Forenede Stater, 98405
    - Northwest NCI Community Oncology Research Program
  - Tacoma, Washington, Forenede Stater, 98405
    - Saint Joseph Medical Center
  - Vancouver, Washington, Forenede Stater, 98664
    - PeaceHealth Southwest Medical Center
  - Wenatchee, Washington, Forenede Stater, 98801
    - Wenatchee Valley Hospital and Clinics
- West Virginia
  - Charleston, West Virginia, Forenede Stater, 25304
    - West Virginia University Charleston Division
  - Huntington, West Virginia, Forenede Stater, 25701
    - Edwards Comprehensive Cancer Center
  - Huntington, West Virginia, Forenede Stater, 25702
    - Saint Mary's Medical Center
  - Morgantown, West Virginia, Forenede Stater, 26506
    - West Virginia University Healthcare
  - Wheeling, West Virginia, Forenede Stater, 26003
    - Wheeling Hospital/Schiffler Cancer Center
- Wisconsin
  - Antigo, Wisconsin, Forenede Stater, 54409
    - Langlade Hospital and Cancer Center
  - Appleton, Wisconsin, Forenede Stater, 54911
    - ThedaCare Regional Cancer Center
  - Burlington, Wisconsin, Forenede Stater, 53105
    - Aurora Cancer Care-Southern Lakes VLCC
  - Eau Claire, Wisconsin, Forenede Stater, 54701
    - HSHS Sacred Heart Hospital
  - Eau Claire, Wisconsin, Forenede Stater, 54701
    - Marshfield Clinic Cancer Center at Sacred Heart
  - Fond Du Lac, Wisconsin, Forenede Stater, 54937
    - Aurora Health Center-Fond du Lac
  - Fond Du Lac, Wisconsin, Forenede Stater, 54935
    - Saint Agnes Hospital/Agnesian Cancer Center
  - Germantown, Wisconsin, Forenede Stater, 53022
    - Aurora Health Care Germantown Health Center
  - Grafton, Wisconsin, Forenede Stater, 53024
    - Aurora Cancer Care-Grafton
  - Green Bay, Wisconsin, Forenede Stater, 54311
    - Aurora BayCare Medical Center
  - Green Bay, Wisconsin, Forenede Stater, 54301
    - Saint Vincent Hospital Cancer Center Green Bay
  - Green Bay, Wisconsin, Forenede Stater, 54303
    - Saint Vincent Hospital Cancer Center at Saint Mary's
  - Green Bay, Wisconsin, Forenede Stater, 54301
    - Bellin Memorial Hospital
  - Green Bay, Wisconsin, Forenede Stater, 54303
    - Green Bay Oncology Limited at Saint Mary's Hospital
  - Green Bay, Wisconsin, Forenede Stater, 54301-3526
    - Green Bay Oncology at Saint Vincent Hospital
  - Johnson Creek, Wisconsin, Forenede Stater, 53038
    - UW Cancer Center Johnson Creek
  - Kenosha, Wisconsin, Forenede Stater, 53142
    - Aurora Cancer Care-Kenosha South
  - La Crosse, Wisconsin, Forenede Stater, 54601
    - Gundersen Lutheran Medical Center
  - Madison, Wisconsin, Forenede Stater, 53717
    - Dean Hematology and Oncology Clinic
  - Madison, Wisconsin, Forenede Stater, 53792
    - University of Wisconsin Carbone Cancer Center
  - Manitowoc, Wisconsin, Forenede Stater, 54221
    - Holy Family Memorial Hospital
  - Marinette, Wisconsin, Forenede Stater, 54143
    - Aurora Bay Area Medical Group-Marinette
  - Marinette, Wisconsin, Forenede Stater, 54143
    - Bay Area Medical Center
  - Marshfield, Wisconsin, Forenede Stater, 54449
    - Marshfield Medical Center-Marshfield
  - Marshfield, Wisconsin, Forenede Stater, 54449
    - Marshfield Medical Center
  - Milwaukee, Wisconsin, Forenede Stater, 53226
    - Medical College of Wisconsin
  - Milwaukee, Wisconsin, Forenede Stater, 53209
    - Aurora Cancer Care-Milwaukee
  - Milwaukee, Wisconsin, Forenede Stater, 53215
    - Aurora Saint Luke's Medical Center
  - Milwaukee, Wisconsin, Forenede Stater, 53233
    - Aurora Sinai Medical Center
  - Milwaukee, Wisconsin, Forenede Stater, 53210
    - Ascension Southeast Wisconsin Hospital - Saint Joseph Campus
  - Minocqua, Wisconsin, Forenede Stater, 54548
    - Marshfield Clinic-Minocqua Center
  - Mukwonago, Wisconsin, Forenede Stater, 53149
    - ProHealth D N Greenwald Center
  - New Richmond, Wisconsin, Forenede Stater, 54017
    - Cancer Center of Western Wisconsin
  - Oconomowoc, Wisconsin, Forenede Stater, 53066
    - ProHealth Oconomowoc Memorial Hospital
  - Oconto Falls, Wisconsin, Forenede Stater, 54154
    - Saint Vincent Hospital Cancer Center at Oconto Falls
  - Oshkosh, Wisconsin, Forenede Stater, 54904
    - Vince Lombardi Cancer Clinic - Oshkosh
  - Racine, Wisconsin, Forenede Stater, 53406
    - Aurora Cancer Care-Racine
  - Rhinelander, Wisconsin, Forenede Stater, 54501
    - Ascension Saint Mary's Hospital
  - Rhinelander, Wisconsin, Forenede Stater, 54501
    - Saint Mary's Hospital
  - Rice Lake, Wisconsin, Forenede Stater, 54868
    - Marshfield Medical Center-Rice Lake
  - Sheboygan, Wisconsin, Forenede Stater, 53081
    - Vince Lombardi Cancer Clinic-Sheboygan
  - Sheboygan, Wisconsin, Forenede Stater, 53081
    - HSHS Saint Nicholas Hospital
  - Stevens Point, Wisconsin, Forenede Stater, 54481
    - Ascension Saint Michael's Hospital
  - Sturgeon Bay, Wisconsin, Forenede Stater, 54235
    - Green Bay Oncology - Sturgeon Bay
  - Summit, Wisconsin, Forenede Stater, 53066
    - Aurora Medical Center in Summit
  - Two Rivers, Wisconsin, Forenede Stater, 54241
    - Vince Lombardi Cancer Clinic-Two Rivers
  - Waukesha, Wisconsin, Forenede Stater, 53188
    - ProHealth Waukesha Memorial Hospital
  - Waukesha, Wisconsin, Forenede Stater, 53188
    - Aurora Cancer Care-Waukesha
  - Wausau, Wisconsin, Forenede Stater, 54401
    - Aspirus Regional Cancer Center
  - Wauwatosa, Wisconsin, Forenede Stater, 53226
    - Aurora Cancer Care-Milwaukee West
  - West Allis, Wisconsin, Forenede Stater, 53227
    - Aurora West Allis Medical Center
  - Weston, Wisconsin, Forenede Stater, 54476
    - Marshfield Medical Center - Weston
  - Weston, Wisconsin, Forenede Stater, 54476
    - Diagnostic and Treatment Center
  - Wisconsin Rapids, Wisconsin, Forenede Stater, 54494
    - Aspirus Cancer Care - Wisconsin Rapids
  - Wisconsin Rapids, Wisconsin, Forenede Stater, 54494
    - Marshfield Clinic - Wisconsin Rapids Center
- Wyoming
  - Casper, Wyoming, Forenede Stater, 82609
    - Rocky Mountain Oncology
  - Sheridan, Wyoming, Forenede Stater, 82801
    - Welch Cancer Center

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

12 år og ældre (Barn, Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Beskrivelse

Inklusionskriterier:

Alle patienter skal have sygdomsfri status dokumenteret ved en fuldstændig fysisk undersøgelse og billeddiagnostiske undersøgelser inden for 4 uger før randomisering; billeddannelsesundersøgelser skal omfatte en total kropspositronemissionstomografi (PET)-computertomografi (CT) scanning (med eller uden hjerne) og hjernemagnetisk resonansbilleddannelse (MRI) eller CT (hvis MR er kontraindiceret); hvis PET-CT ikke kan udføres, bør CT af nakke, bryst, mave og bækken udføres
- Hvis en CT af en eller anden grund ikke kan udføres, kan der i stedet foretages en MR. eventuelle andre billeddiagnostiske undersøgelser, hvis de udføres (f.eks. knoglescanning), må ikke vise tegn på sygdom
Patienter skal have primært kutant melanom, der tilhører en af følgende American Joint Commission on Cancer (AJCC) stadier (2009 AJCC Melanoma Staging System):
- Trin IIIB
  - T1-4b N1a M0
  - T1-4b N2a M0
  - T1-4b N1b M0
  - T1-4b N2b M0
  - T1-4b N2c M0
- Trin IIIC
  - T1-4b N1b M0
  - T1-4b N2b M0
  - T1-4b N2c M0
  - Enhver T N3 M0
- Fase IV
  - M1a
  - M1b
  - BEMÆRK: Patienter med stadium IV melanom skal have normal lactatdehydrogenase (LDH) og enten fjerne hud-, subkutan-, lymfeknude- eller lungemetastaser, men ingen andre viscerale metastaser for at være berettiget; for patienter med resekeret stadium IV melanom skal LDH inden for den institutionelle øvre normalgrænse (ULN) dokumenteres inden for 4 uger før randomisering
Patienter med sygdomstilbagefald efter tilstrækkelig kirurgisk excision af det oprindelige primære kutane/ukendte primære melanom er tilladt, selvom de ikke opfylder de strenge stadiekriterier, men kun som følger:
- Recidiv i et regionalt lymfeknudebassin efter en forudgående fuldstændig lymfeknudedissektion; recidiverende sygdom skal resekeres fuldstændigt kirurgisk med frie marginer
- Tilbagefald i form af in-transit- eller satellitmetastaser eller fjerne hud/subkutane, nodal- eller lungemetastaser, der er fuldstændig kirurgisk resekeret med frie marginer
- Recidiv i et regionalt lymfeknudebassin; recidiverende sygdom skal resekeres fuldstændigt kirurgisk med frie marginer
Patienter med ukendt primært melanom (Tx), som præsenterer med kutane, subkutane, nodale og/eller lungemetastaser, som er fuldstændig kirurgisk resekeret med frie marginer, er tilladt; disse patienter er tilladt, selvom de ikke opfylder de strenge stadiekriterier; for stadium IV-patienter skal LDH inden for den institutionelle ULN dokumenteres inden for 4 uger før randomisering (M1c er ikke kvalificeret)
- BEMÆRK: alle forsøgspersoner skal klassificeres som IIIB, IIIC, M1a eller M1b, inklusive forsøgspersoner med tilbagevendende sygdom efter tilstrækkelig kirurgisk excision af det oprindelige primære melanom; det vil sige, at det behandlende team/lægens investigator skal gennemgå en overordnet TNM-status (som inkluderer primær tumorpræsentation og sygdomsrecidivstatus) og give en betegnelse for IIIB, IIIC, M1a eller M1b
Patienter skal randomiseres inden for 84 dage (12 uger) efter kirurgisk resektion; hvis mere end et kirurgisk indgreb er påkrævet for at gøre patienten sygdomsfri, skal patienten randomiseres inden for 12 uger efter sidste operation
- BEMÆRK: Patienter med klinisk positive lymfeknuder for melanom involvering eller dem med positive lymfeknuder identificeret gennem lymfoscintigrafiske og/eller farvestoflymfografiske teknikker i lysken, aksillen eller halsen bør have yderligere lymfadenektomi på disse steder; den komplette lymfeknudedissektionsprocedure vil blive betragtet som den sidste operation ved at tælle de 84 dage, medmindre en efterfølgende kirurgisk procedure(r) var klinisk påkrævet for at sikre sygdomsfri status
Patienter skal have Eastern Cooperative Oncology Group (ECOG) præstationsstatus på 0-1
I betragtning af, at alvorlige bivirkninger kan forekomme med ipilimumab og IFN-alfa, og at disse kan påvirke en patients velbefindende, er det muligt, at forekomsten af andre alvorlige bivirkninger (SAE'er) kan have en alvorlig indvirkning på en underliggende tilstand af mental depression og føre til selvmordstanker ; derfor bør patienter omhyggeligt screenes for depression ved baseline, og hvis der er indikationer eller en historie med depression, anbefales det kraftigt, at disse patienter følges tæt sammen med adfærdsmæssig sundhed eller psykiatrisk medicinsk støtte; patienter med en etableret diagnose af depression, som efter investigators vurdering kan gøre administration af IFN-alfa eller ipilimumab farlig, bør ikke optages i denne protokol; risici og fordele ved at blive behandlet med standard adjuverende IFN-alfa bør afvejes meget nøje i samråd med adfærdssundhed eller psykiatri
På grund af den mulige effekt af behandling med ipilimumab på det immunologiske respons på infektionssygdomsvacciner, må patienter ikke have fået nogen infektionssygdomsvaccination (f.eks. standardinfluenza, H1N1-influenza, pneumokok, meningokok, stivkrampetoksoid) inden for 4 uger før randomisering
WOCBP skal bruge en passende præventionsmetode for at undgå graviditet under hele undersøgelsen og i op til 26 uger efter den sidste dosis af ipilimumab eller HDI på en sådan måde, at risikoen for graviditet minimeres; kvinder, der bruger orale præventionsmidler, andre hormonelle præventionsmidler (vaginale produkter, hudplastre eller implanterede eller injicerbare produkter), eller mekaniske produkter såsom en intrauterin enhed eller barrieremetoder (membran, kondomer, sæddræbende midler) for at forhindre graviditet, eller praktiserer abstinenser eller hvor deres partner er steril (f.eks. vasektomi), bør anses for at være i den fødedygtige alder
- Mænd med fædrepotentiale og WOCBP skal bruge en passende præventionsmetode for at undgå undfangelse/graviditet under hele undersøgelsen og i op til 26 uger efter den sidste dosis ipilimumab eller HDI på en sådan måde, at risikoen for graviditet minimeres; mænd eller WOCBP, der er uvillige eller ude af stand til strengt at følge dette krav, er ikke berettigede
- WOCBP er ikke berettiget, hvis de opfylder et af følgende:
  - En positiv graviditetstest ved baseline
  - Gravid eller ammende
Hvide blodlegemer (WBC) >= 3.000/uL (opnået inden for 4 uger før randomisering)
Absolut neutrofiltal (ANC) >= 1.500/uL (opnået inden for 4 uger før randomisering)
Blodplader >= 100 x 10^3/uL (opnået inden for 4 uger før randomisering)
Hæmoglobin >= 10 g/dL (opnået inden for 4 uger før randomisering)
Serumkreatinin =< 1,5 mg/dL (opnået inden for 4 uger før randomisering)
Aspartataminotransferase (AST)/alaninaminotransferase (ALT) =< 2,5 x ULN (opnået inden for 4 uger før randomisering)
Serumbilirubin =< 1,5 x ULN (undtagen patienter med Gilberts syndrom, som skal have en total bilirubin på mindre end 3,0 mg/dL) (opnået inden for 4 uger før randomisering)
Ingen aktiv eller kronisk infektion med humant immundefektvirus (HIV), hepatitis B eller hepatitis C på grund af de ukendte virkninger af ipilimumab; patienter skal have negativ test for HIV, hepatitis B-virus (HBV), hepatitis C-virus (HCV) inden for 4 uger før randomisering

Ekskluderingskriterier:

Patienter må ikke have modtaget nogen adjuverende behandling (kemoterapi, bioterapi eller perfusion af lemmer) efter de resektion(er), der gør dem kvalificerede til dette forsøg
- BEMÆRK: Tidligere strålebehandling, inklusive efter den kirurgiske resektion, er tilladt, så længe der er gået 21 dage mellem strålingen og påbegyndelsen af denne adjuverende systemiske terapi
Tidligere behandling med anti-cytotoksisk T-lymfocytantigen 4 (CTLA4) monoklonale antistoffer eller tidligere CTLA-4-hæmmer eller agonist eller tidligere clusters of differentiation (CD)137-agonist eller tidligere interferon-alfa er ikke tilladt; andre former for forudgående behandling for melanom (f.eks. aldesleukin [IL-2], antitumorvaccine, kemoterapi) er tilladt, hvis de gives før de resektion(er), der gør patienten kvalificeret til dette forsøg, men disse skal have afsluttet mindst 4 uger før randomisering
Patienter må ikke have en aktiv infektion, der kræver aktuel behandling med parenterale antibiotika
Patienter må ikke have andre væsentlige medicinske, kirurgiske eller psykiatriske tilstande eller kræve nogen form for medicin eller behandling, der efter investigatorens mening kan forstyrre compliance, gøre administrationen af ipilimumab eller HDI farlig eller sløre fortolkningen af uønskede hændelser (AE'er), såsom en tilstand forbundet med hyppig diarré; patienter med en baseline af hyppig diarré (f. irritabel tyktarm) er ikke kvalificerede på grund af vanskeligheden ved at fortolke senere forventede gastrointestinale toksiciteter, der kan føre til suboptimal behandling og komplikationer
Patienter må ikke have en dokumenteret anamnese med inflammatorisk tarmsygdom (herunder colitis ulcerosa og Crohns sygdom) eller divertikulitis (historie med divertikulose er tilladt)
Patienter må ikke have autoimmune lidelser eller tilstande med immunsuppression, der kræver igangværende behandling med systemiske kortikosteroider (eller andre systemiske immunsuppressiva), inklusive orale steroider (dvs. prednison, dexamethason) eller kontinuerlig brug af topiske steroidcremer eller -salver eller oftalmologiske steroider; en historie med lejlighedsvis (men ikke kontinuerlig) brug af steroidinhalatorer er tilladt; erstatningsdoser af steroider til patienter med binyrebarkinsufficiens er tilladt; patienter, der ophører med at bruge disse klasser af medicin i mindst 2 uger før randomisering, er kvalificerede, hvis det efter den behandlende læges efterforskers vurdering ikke er sandsynligt, at patienten vil kræve genoptagelse af behandlingen med disse klasser af lægemidler under undersøgelsen
- Udelukkelse fra denne undersøgelse omfatter også patienter med en historie med symptomatisk autoimmun sygdom (f.eks. rheumatoid arthritis, systemisk progressiv sklerose [sklerodermi], systemisk lupus erythematosus, Sjogrens syndrom, autoimmun vaskulitis [f.eks. Wegeners granulomatose]); motorisk neuropati betragtet som af autoimmun oprindelse (f.eks. Guillain-Barre syndrom og Myasthenia Gravis); anden autoimmun sygdom i centralnervesystemet (CNS) (f.eks. poliomyelitis, multipel sklerose)
- Patienter med autoimmun hypothyroid sygdom eller type I diabetes i erstatningsbehandling er berettiget
Patienter må ikke være fanger eller forsøgspersoner, der er tvangsfængslet (ufrivilligt fængslet) til behandling af enten en psykiatrisk eller fysisk (f.eks. smitsom) sygdom; dette skyldes bekymringer om emnets sikkerhed og overholdelse af undersøgelsesprocedurer
Patienter, der har andre aktuelle maligniteter, er ikke kvalificerede; patienter med andre maligniteter er kvalificerede, hvis de har været kontinuerligt sygdomsfri i > 5 år forud for randomiseringstidspunktet; patienter med tidligere anamnese på et hvilket som helst tidspunkt af in situ cancer, lobular carcinom i brystet in situ, cervix cancer in situ, atypisk melanocytisk hyperplasi eller melanom in situ er kvalificerede; patienter med tidligere basal- eller pladehudkræft i anamnesen er kvalificerede; patienter, der har haft flere primære melanomer, er berettigede
Kvinder må ikke være gravide eller amme på grund af de ukendte virkninger af ipilimumab og HDI på undfangelsen og fosteret; alle kvinder i den fødedygtige alder skal have en blodprøve eller urinundersøgelse under screening for at udelukke graviditet
- BEMÆRK: en kvinde i den fødedygtige alder (WOCBP) er enhver kvinde, uanset seksuel orientering eller om de har gennemgået tubal ligering, som opfylder følgende kriterier: 1) ikke har gennemgået en hysterektomi eller bilateral ooforektomi; eller 2) ikke har været naturligt postmenopausal i mindst 24 på hinanden følgende måneder (dvs. har haft menstruation på noget tidspunkt i de foregående 24 på hinanden følgende måneder); postmenopause er defineret som:
  - Amenoré >= 12 på hinanden følgende måneder uden anden årsag, eller
  - For kvinder med uregelmæssige menstruationer og tager hormonsubstitutionsterapi (HRT), et dokumenteret serum follikelstimulerende hormon (FSH) niveau >= 35 mIU/ml

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Primært formål: Behandling
Tildeling: Randomiseret
Interventionel model: Parallel tildeling
Maskning: Ingen (Åben etiket)

Antal våben

Våben og indgreb

Deltagergruppe / Arm	Intervention / Behandling
Eksperimentel: Arm A (alder >= 18, højdosis ipilimumab) Patienter får induktionshøjdosis ipilimumab IV over 90 minutter på dag 1. Behandlingen gentages hver 21. dag i i alt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Fra og med uge 24 får patienterne vedligeholdelseshøjdosis ipilimumab IV over 90 minutter på dag 1. Behandlingen gentages hver 90. dag i maksimalt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. (lukket optjening pr. 4/4/14) (voksenoptjening er afsluttet til arme A, B og C pr. 15/8/2014)	Andet: Livskvalitetsvurdering Hjælpestudier Andre navne: Livskvalitetsvurdering Biologisk: Ipilimumab Givet IV Andre navne: Anti-cytotoksisk T-lymfocyt-associeret antigen-4 monoklonalt antistof BMS-734016 Ipilimumab Biosimilar CS1002 MDX-010 MDX-CTLA4 Yervoy
Eksperimentel: Arm B (alder >= 18, rekombinant interferon alfa-2b) Patienter får højdosis rekombinant interferon alfa-2b IV på dag 1-5, 8-12, 15-19 og 22-26 i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienterne modtager derefter vedligeholdelseshøjdosis rekombinant interferon alpha-2b SC på dag 1, 3 og 5. Behandlingen gentages hver uge i 48 uger i fravær af sygdomsprogression eller uacceptabel toksicitet. (voksenopbygning er afsluttet til arme A, B og C pr. 15/8/2014)	Andet: Livskvalitetsvurdering Hjælpestudier Andre navne: Livskvalitetsvurdering Biologisk: Rekombinant Interferon Alfa-2b Givet IV og SC Andre navne: Alfatronol Glucoferon Heberon Alfa IFN alfa-2B Interferon alfa 2b Interferon Alfa-2B Interferon Alpha-2b Intron A Sch 30500 Urifron Viraferon
Eksperimentel: Arm C (alder >= 18, lavdosis ipilimumab) Patienter får induktion i lavdosis ipilimumab IV over 90 minutter på dag 1. Behandlingen gentages hver 21. dag i i alt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Fra uge 24 får patienterne vedligeholdelses lavdosis ipilimumab IV over 90 minutter på dag 1. Behandlingen gentages hver 90. dag i maksimalt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. (voksenopbygning er afsluttet til arme A, B og C pr. 15/8/2014)	Andet: Livskvalitetsvurdering Hjælpestudier Andre navne: Livskvalitetsvurdering Biologisk: Ipilimumab Givet IV Andre navne: Anti-cytotoksisk T-lymfocyt-associeret antigen-4 monoklonalt antistof BMS-734016 Ipilimumab Biosimilar CS1002 MDX-010 MDX-CTLA4 Yervoy
Eksperimentel: Arm D (12-17 år, højdosis ipilimumab) Patienter får induktionshøjdosis ipilimumab IV over 90 minutter på dag 1. Behandlingen gentages hver 21. dag i i alt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Fra og med uge 24 får patienterne vedligeholdelseshøjdosis ipilimumab IV over 90 minutter på dag 1. Behandlingen gentages hver 90. dag i maksimalt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet.	Biologisk: Ipilimumab Givet IV Andre navne: Anti-cytotoksisk T-lymfocyt-associeret antigen-4 monoklonalt antistof BMS-734016 Ipilimumab Biosimilar CS1002 MDX-010 MDX-CTLA4 Yervoy
Eksperimentel: Arm E (alder 12-17, rekombinant interferon alfa-2b) Patienter får højdosis rekombinant interferon alfa-2b IV på dag 1-5, 8-12, 15-19 og 22-26 i fravær af sygdomsprogression eller uacceptabel toksicitet. Patienterne modtager derefter vedligeholdelseshøjdosis rekombinant interferon alpha-2b SC på dag 1, 3 og 5. Behandlingen gentages hver uge i 48 uger i fravær af sygdomsprogression eller uacceptabel toksicitet. (12-17 år)	Biologisk: Rekombinant Interferon Alfa-2b Givet IV og SC Andre navne: Alfatronol Glucoferon Heberon Alfa IFN alfa-2B Interferon alfa 2b Interferon Alfa-2B Interferon Alpha-2b Intron A Sch 30500 Urifron Viraferon
Eksperimentel: Arm F (alder 12-17, lavdosis ipilimumab) Patienter får induktion i lavdosis ipilimumab IV over 90 minutter på dag 1. Behandlingen gentages hver 21. dag i i alt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. Fra uge 24 får patienterne vedligeholdelses lavdosis ipilimumab IV over 90 minutter på dag 1. Behandlingen gentages hver 90. dag i maksimalt 4 cyklusser i fravær af sygdomsprogression eller uacceptabel toksicitet. (12-17 år)	Biologisk: Ipilimumab Givet IV Andre navne: Anti-cytotoksisk T-lymfocyt-associeret antigen-4 monoklonalt antistof BMS-734016 Ipilimumab Biosimilar CS1002 MDX-010 MDX-CTLA4 Yervoy

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Gentagelsesfri overlevelse (RFS; Arm B [HDI] vs. Arm C [LIP]) Tidsramme: Vurderes hver 3. måned i 2 år, derefter hver 6. måned i år 3-5 og derefter årligt op til 8 år	Gentagelsesfri overlevelse er defineret som tiden fra randomisering til gentagelse eller død, alt efter hvad der indtræffer først. Følgende kriterier udgør det eneste acceptable bevis på sygdomsgentagelse. Lunge og lever: Positiv cytologi eller biopsi i nærvær af en enkelt ny læsion eller forekomsten af flere læsioner i overensstemmelse med metastatisk sygdom. Centralnervesystemet: En positiv hjerne-CT- eller MR-scanning eller CSF-cytologi. Kutan, subkutan og lymfeknudetilbagefald: Positiv cytologi eller biopsi ved tilstedeværelse af en enkelt ny læsion eller forekomsten af flere læsioner i overensstemmelse med metastatisk sygdom. Knogle og andre organer: Positiv cytologi eller biopsi i nærværelse af en enkelt ny læsion eller forekomsten af flere læsioner i overensstemmelse med metastatisk sygdom identificeret på to forskellige radiologiske undersøgelser: dvs. positiv nuklear knoglescanning eller PET-scanning og kontrast GI-serier eller ultralyd, Røntgen eller CT af abdomen for abdominal sygdom.	Vurderes hver 3. måned i 2 år, derefter hver 6. måned i år 3-5 og derefter årligt op til 8 år
5-års samlet overlevelse (OS) rate (arm B [HDI] vs. arm C [LIP]) Tidsramme: Vurderes hver 3. måned i 2 år, derefter hver 6. måned i år 3-5	Samlet overlevelse er defineret som tiden fra randomisering til død eller dato sidst kendt i live.	Vurderes hver 3. måned i 2 år, derefter hver 6. måned i år 3-5
Gentagelsesfri overlevelse (RFS; Arm A [HIP] vs. Arm B [HDI]) Tidsramme: Vurderes hver 3. måned i 2 år, derefter hver 6. måned i år 3-5 og derefter årligt op til 8 år	Gentagelsesfri overlevelse er defineret som tiden fra randomisering til gentagelse eller død, alt efter hvad der indtræffer først. Følgende kriterier udgør det eneste acceptable bevis på sygdomsgentagelse. Lunge og lever: Positiv cytologi eller biopsi i nærvær af en enkelt ny læsion eller forekomsten af flere læsioner i overensstemmelse med metastatisk sygdom. Centralnervesystemet: En positiv hjerne-CT- eller MR-scanning eller CSF-cytologi. Kutan, subkutan og lymfeknudetilbagefald: Positiv cytologi eller biopsi ved tilstedeværelse af en enkelt ny læsion eller forekomsten af flere læsioner i overensstemmelse med metastatisk sygdom. Knogle og andre organer: Positiv cytologi eller biopsi i nærværelse af en enkelt ny læsion eller forekomsten af flere læsioner i overensstemmelse med metastatisk sygdom identificeret på to forskellige radiologiske undersøgelser: dvs. positiv nuklear knoglescanning eller PET-scanning og kontrast GI-serier eller ultralyd, Røntgen eller CT af abdomen for abdominal sygdom.	Vurderes hver 3. måned i 2 år, derefter hver 6. måned i år 3-5 og derefter årligt op til 8 år
5-års samlet overlevelse (OS) rate (arm A [HIP] vs. arm B [HDI]) Tidsramme: Vurderes hver 3. måned i 2 år, derefter hver 6. måned i år 3-5	Samlet overlevelse er defineret som tiden fra randomisering til død eller dato sidst kendt i live.	Vurderes hver 3. måned i 2 år, derefter hver 6. måned i år 3-5

Sekundære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Ændring i FACT-G (Functional Assessment of Cancer Therapy - General) Total score fra baseline til 3 måneder Tidsramme: Vurderet ved baseline og 3 måneder	Den Funktionelle Vurdering af Kræftterapi - Generelt (FACT-G) er et spørgeskema på 27 punkter, der har fire måleområder (fysisk velvære, socialt/familiemæssigt velvære, følelsesmæssigt velvære og funktionelt velvære) med en skala fra 0-4. Den samlede FACT-G score ligger mellem 0 og 108. Jo højere score, jo bedre livskvalitet. Ændring i FACT-G total score fra baseline til 3 måneder blev beregnet som måned 3 score - baseline score.	Vurderet ved baseline og 3 måneder
Ændring i FACIT-D (Functional Assessment of Cancer Therapy - Diarrhea) Diarré Subscale Score fra baseline til 3 måneder Tidsramme: Vurderet ved baseline og 3 måneder	Diarré-underskalaen til The Functional Assessment of Chronic Illness Therapy - Diarrhea (FACIT-D) er et spørgeskema på 11 punkter med en skala fra 0-4. FACIT-D diarré subskalaen scorer mellem 0 og 44. Jo højere score, jo bedre livskvalitet. Ændring i FACIT-D diarré subskala score fra baseline til 3 måneder blev beregnet som måned 3 score - baseline score.	Vurderet ved baseline og 3 måneder
Ændring i FACT-BRM (Functional Assessment of Cancer Therapy - Biologisk Respons Modifiers) Samlet score fra baseline til 3 måneder Tidsramme: Vurderet ved baseline og 3 måneder	Den funktionelle vurdering af kræftterapi - biologiske responsmodifikatorer (FACT-BRM) er et spørgeskema, der inkluderer FACT-G (den funktionelle vurdering af kræftterapi - generelt) og yderligere afsnit, der omhandler fysiske og mentale livskvalitetsaspekter. Det er et spørgeskema på 40 punkter med en skala fra 0-4. Den samlede FACT-BRM score ligger mellem 0 og 160. Jo højere score, jo bedre livskvalitet. Ændring i FACT-BRM total score fra baseline til 3 måneder beregnes som måned 3 score - baseline score.	Vurderet ved baseline og 3 måneder

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

National Cancer Institute (NCI)

Efterforskere

Ledende efterforsker: Ahmad Tarhini, ECOG-ACRIN Cancer Research Group

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

25. maj 2011

Primær færdiggørelse (Faktiske)

15. februar 2019

Studieafslutning

26. juni 2035

Datoer for studieregistrering

Først indsendt

8. januar 2011

Først indsendt, der opfyldte QC-kriterier

8. januar 2011

Først opslået (Anslået)

11. januar 2011

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

15. februar 2024

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

14. februar 2024

Sidst verificeret

1. januar 2024

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

NCI-2011-02649 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
U10CA180820 (U.S. NIH-bevilling/kontrakt)
U24CA196172 (U.S. NIH-bevilling/kontrakt)
U10CA021115 (U.S. NIH-bevilling/kontrakt)
E1609 (Anden identifikator: CTEP)
P50CA121973 (U.S. NIH-bevilling/kontrakt)
CDR0000692568
ECOG-E1609

Plan for individuelle deltagerdata (IPD)

IPD-planbeskrivelse

Individuelle deltagerdata kan stilles til rådighed efter anmodning i henhold til ECOG-ACRINs datadelingspolitik.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Fase IV kutan melanom AJCC v6 og v7

National Cancer Institute (NCI)

Afsluttet

Sargramostim, Vaccineterapi eller Sargramostim og Vaccineterapi til forebyggelse af sygdomstilbagefald hos patienter med melanom, der er blevet fjernet ved kirurgi

Fase IV kutan melanom AJCC v6 og v7 | Tilbagevendende melanom | Fase IIIC kutan melanom AJCC v7 | Slimhinde melanom | Iris melanom | Fase IIIA kutan melanom AJCC v7 | Fase IIIB kutan melanom AJCC v7 | Stage IV Uveal Melanoma AJCC v7 | Medium/Large Size Posterior Uveal Melanom | Tilbagevendende uveal melanom | Stage IIIA Uveal Melanoma AJCC v7 og andre forhold

Forenede Stater
M.D. Anderson Cancer Center
National Cancer Institute (NCI)

Afsluttet

Neoadjuvant og Adjuvant Checkpoint Blockade

Fase IV kutan melanom AJCC v6 og v7 | Okulært melanom | Fase IIIC kutan melanom AJCC v7 | Kutant melanom | Slimhinde melanom | Fase IIIB kutan melanom AJCC v7 | Stage IV Uveal Melanoma AJCC v7 | Stadie IIIB Uveal Melanoma AJCC v7 | Stage IIIC Uveal Melanoma AJCC v7 | Stadie III Akral Lentiginøst Melanom AJCC... og andre forhold

Forenede Stater
Academic and Community Cancer Research United
National Cancer Institute (NCI)

Afsluttet

Nab-Paclitaxel og Bevacizumab eller Ipilimumab som førstelinjebehandling til behandling af patienter med trin IV melanom, der ikke kan fjernes ved kirurgi

Metastatisk melanom | Fase IV kutan melanom AJCC v6 og v7 | Uoperabelt melanom | Slimhinde melanom | Stage IV Uveal Melanoma AJCC v7

Forenede Stater
National Cancer Institute (NCI)

Trukket tilbage

Glembatumumab Vedotin, Nivolumab og Ipilimumab til behandling af patienter med avancerede metastatiske solide tumorer, der ikke kan fjernes ved kirurgi

Metastatisk melanom | Fase III kutan melanom AJCC v7 | Fase IV kutan melanom AJCC v6 og v7 | Avanceret malignt fast neoplasma | Metastatisk malignt fast neoplasma | Fase IIIC kutan melanom AJCC v7 | Østrogenreceptor negativ | HER2/Neu negativ | Progesteronreceptor negativ | Triple-negativt brystkarcinom | Uoprettelig... og andre forhold

Kliniske forsøg med Livskvalitetsvurdering

Seoul National University Hospital

Trukket tilbage

Virkninger af præoperativ angst og depression på kortsigtet postoperativ restitution ved tidlig gastrisk cancer

Depression | Postoperative komplikationer | Angst | Mestringsadfærd

Korea, Republikken
Memorial Sloan Kettering Cancer Center

Afsluttet

Indvirkning af palliativ kateterplacering på livskvaliteten for patienter med refraktær ascites

Ascites

Forenede Stater
Latin American Cooperative Oncology Group
Roche Pharma AG; EVA - Grupo Brasileiro de Tumores Ginecológicos

Afsluttet

Prospektiv evaluering af patienter med livmoderhalskræft i brasilianske sundhedsinstitutioner - EVITA I-undersøgelsen

Livmoderhalskræft

Brasilien
Kutahya Health Sciences University

Afsluttet

Tyrkisk gyldighed og pålidelighed af smertekatastrofiserende scale-Child (PCS-C)

Kronisk smerte | Juvenil idiopatisk arthritis

Kalkun
University of Florida

Afsluttet

Medlidenhedstræthed hos ED-udbydere

Medfølelse Træthed

Forenede Stater
Maastricht University
TNO; Netherlands Instititute for Health Services Research; University of...

Afsluttet

Effektivitet og implementering af værktøjet til vurdering af byrde ved kroniske lidelser (ABCC)

Hjertefejl | Diabetes mellitus, type 2 | Kronisk obstruktiv lungesygdom | Astma

Holland
World Vision Canada
Ryerson University; World Health Organization; Global Affairs Canada; Ministry...

Afsluttet

Klinisk evaluering af brugen af en mHealth-intervention om plejekvalitet

Diarré | Malaria | Akut luftvejsinfektion
University Hospital, Strasbourg, France

Afsluttet

Validering af en pædiatrisk billedversion af QOR-15 Postoperatory Functional Recovery Scale - QoR-15 Pédiatric

Kirurgisk indgreb | Mindre

Frankrig
King's College London
Guy's and St Thomas' NHS Foundation Trust

Afsluttet

Livskvalitetsværktøj til IBD (QOLITI)

Inflammatorisk tarmsygdom

Det Forenede Kongerige
Ondokuz Mayıs University
Samsun Education and Research Hospital

Afsluttet

Tyrkisk gyldighed og pålidelighed af Recovery Scale QoR-15 (Qor-15)

Sundhedsadfærd

Kalkun

Ipilimumab eller højdosis interferon Alfa-2b til behandling af patienter med højrisikostadie III-IV melanom, der er blevet fjernet ved kirurgi

Et fase III randomiseret studie af adjuverende ipilimumab anti-CTLA4-terapi versus højdosis interferon a-2b til resekeret højrisiko melanom

Studieoversigt

Status

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Undersøgelsestype

Tilmelding (Faktiske)

Fase

Kontakter og lokationer

Studiesteder

Deltagelseskriterier

Berettigelseskriterier

Aldre berettiget til at studere

Tager imod sunde frivillige

Beskrivelse

Studieplan

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Antal våben

Våben og indgreb

Deltagergruppe / Arm

Intervention / Behandling

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Sekundære resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Samarbejdspartnere og efterforskere

Sponsor

Efterforskere

Publikationer og nyttige links

Generelle publikationer

Datoer for undersøgelser

Studer store datoer

Studiestart (Faktiske)

Primær færdiggørelse (Faktiske)

Studieafslutning

Datoer for studieregistrering

Først indsendt

Først indsendt, der opfyldte QC-kriterier

Først opslået (Anslået)

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

Sidst verificeret

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

Plan for individuelle deltagerdata (IPD)

IPD-planbeskrivelse

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Studerer et amerikansk FDA-reguleret enhedsprodukt

Kliniske forsøg med Fase IV kutan melanom AJCC v6 og v7

Kliniske forsøg med Livskvalitetsvurdering

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Qatar

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer